First and Foremost, Protect The Middle

COVID-19 first erupted late in the year Ji-Hai (2019), which represents the warmest period in the entire 60-year Jia-Zi cycle designated by the traditional calendric system of the Heavenly Stems and Earthly Branches. Winter is normally characterized by cold weather, but this year’s winter was warm instead, creating an abnormal climate pattern that most likely aided the eruption of this disease. The Treatise on the Differential Treatment of Warm Disease (Wen bing Tiao bian) states: “Winter is supposed to be cold, but if it turns out to be warm instead, then yang is not going into its customary state of storage and the populace will fall ill with warm diseases as a result.” The author Wu Tang (1758-1836) also remarked elsewhere “Warm diseases can be differentiated into wind fevers (feng wen), heat fevers (wen re), and epidemic fevers (wen yi)… All pathogens that cause warm disease enter through the nose and mouth, and advance deeper and downward from there.” In similar fashion, the government’s standardized treatment approach has made it clear that this disease is transmitted via fine droplets originating from the respiratory tract. The disease first erupted in winter moreover, and was caused by the novel corona virus a pathogen that exhibits highly contagious and pandemic qualities. Just like in Wu Youke’s (1582-1652) classic definition of an epidemic “Epidemic febrile diseases can occur during any season. The epidemic soaks up the pestilent qi between Heaven and Earth… and when it arrives, everyone who comes in contact with it—no matter whether old or young or weak or strong—will become infected.”

Most importantly, what an investigation of  COVID 19 by Traditional Chinese Medicine (TCM) can reveal for us in the face of a widening epidemic are the keys to its prevention.  In addition to good hygiene practices and social distancing regulations that are being widely enacted, TCM can inform us on the actions that we can all take right now for ourselves and our patients to increase resistance to Covid-19.


A virus must find the appropriate terrain within which to take hold and replicate. This particular one seems to prefer damp, stagnant conditions. This means adjusting dietary choices to prevent damage to the Spleen and Stomach yang qi by eating lighter, easy to digest, mostly warm, cooked foods. Visiting the supermarket yesterday, I noticed that the very foods we should be cutting back on were the ones that had been completely bought out, namely meat, milk, yogurt and eggs.

Cut back on or completely avoid processed foods, sweets, alcoholic beverages, and any cold and frozen items from the refrigerator/freezer.

Augment meal preparation with plenty of fresh herbs and fragrant spices. If juicing is part of your daily health regimen, stick mostly to vegetable juices and supplement with fresh ginger, turmeric, pepper, parsley, coriander and small amounts of garlic.

Keep up with basic daily supplements like pro-biotics, Vitamins C and D and trace minerals.

Add Chinese herbal medicine into your daily health regimen: ask Dr. Kienitz about preventative formulas for the respiratory system, colds and flu’s


Exercise helps alleviate all forms of stagnation, dispel constrained heat through sweating and keep the surface open to alleviate pressure on the respiratory system.

Those with an established exercise routine should stick with it; those who don’t can start with something as simple as brisk walking 30-40 minutes a day.

If you feel more comfortable exercising at home, there are any number of  YouTube channels dedicated to body weight interval training circuits, yoga and calisthenics; 30-45 min of sustained elevated heart rate to break a light sweat is sufficient.


With all of the cancellations and closings going on, invest that time in recharging your vitality extending that opportunity for the Kidney to store. Sleep is the foundation of immunity; aim for 8-9 hours of good quality sleep each night and schedule in a short nap period during the day.


TCM emphasizes the importance of the intimate connection between spirit ( shen) and essence (쑹 jing) as the foundation for the orderly function of vital qi. When the spirit is strongly identified with essence, meaning we are calmly present and attuned to our life situation, immunity will flourish. Our body’s natural discerning wisdom will clearly distinguish “what is you from what is not” and your immune system will take action accordingly. Nothing disturbs the clarity of this integration of mind and body like the cascading effects of continuous adrenal stimulation brought on by fear and panic. The simple fact is that while highly communicable, the virulence and mortality risk associated with this virus is fortunately low for otherwise healthy individuals. News and social media rely largely on a negative emotional response in order to keep their audience engaged; try not to get caught up in this circle of fear and frustration.

As we all know from experience, decisions made from a place of anxiety for ourselves or others are often likely to produce unsatisfactory outcomes. This includes rushing to apply treatment strategies, whether eastern or western, those have been published as effective for “fighting the virus” without first pausing to assess the current state of our personal health. Begin with a clear and careful assessment of your own vulnerability as well as that of immediate family members and exercise an appropriate corresponding level of caution in deciding how best to proceed. If you are feeling vulnerable and unsure of how best to apply these recommendations to your personal situation, please reach out to myself or another qualified medical provider or schedule a tele-medicine session.

I would like to conclude with the simple reminder that no effort is wasted when it comes to encouraging health and vitality both in ourselves as well as in those around us in order to bring this public health challenge to a timely conclusion. It is abundantly clear from the classical emphasis on the relationship between unseasonably warm temperatures and the failure to store yang qi both on an individual and universal level as an essential precondition for an epidemic of this nature, that as the rate of human induced climate change continues to accelerate, episodes of this type are only going to increase in frequency. It is yet another way we see the inextricable bond between humanity and nature manifest (天 人 合 一 tian ren he yi) and in moments like these, feel the sense of shared responsibility to care for the well-being of ourselves and one another.

Yours in good health,

Robert Kienitz, DTCM

Cultivation of Mind

Se shen is the cultivated mind, yang shen is the conservation of mind and tao shen the regulation of mind are methods of keeping physically and mentally healthy by regulating the spirit, consciousness and thinking.

A sound mind can be kept, disease prevented and life prolonged by cultivating the mind. To be specific, this entails preserving a tranquil mind, taking care of emotional activities and cultivating mindwill in conformity to the four seasons.

Preserving a tranquil mind means to keep peace, quiet and implement that rationally. This is the principle of maintaining a sound mind and includes the following aspects.

First, being free from hedonism and yearning, when improper thoughts and desires come to the mind unchecked the mental qi becomes disturbed. Keeping a peaceful and carefree mind and ridding oneself of improper desires as a way to prolong life. The lessening of desires will erase an unnecessary load on the mind and help maintain generosity and unselfishness and keep a peaceful and sound mind which keeps one physically and mentally healthy. Being free from hedonism and yearning is the guiding principle of health conservation; the so called maintaining in the state of quietness is the most important tasks in keeping fit. To be free from hedonism and yearning one must convince oneself with reasoning, i.e., to understand well what the addiction to desires may inflict on the human body. If one keeps a clear and quiet mind, abstains from improper desires and understands that fame and position will harm virtue and not seek them instead of forcefully suppressing ones longings. If one tries too hard to suppress the desire for fame, wealth and position, those desires will not cease and one will fail in creating a state of quietness and peace of mind.

It is therefore imperative to cultivate noble ethics and foster lofty values, fully understanding the harms of seeking fame, wealth and position may bring about in order to have a change in ones worldview and see the substance of human affairs of life. If one adheres firmly to the rules of the development of things the improper desires will diminish by themselves resulting in a fresh and happy mind and peace and quiet will be will be obtained without striving for it. Besides being free from hedonism and yearning, the extermination of the six evils and adopt a correct attitude towards personal gains and losses. The six evils refers to fame, wealth, sexuality and ‘song’, gold, silver and other treasures, delicious food, flattery and arrogance and jealousy. Unless the six evils are exterminated, various anxieties will entangle the mind and keep the mind from peace and quiet. Seeking fame and wealth, indulging in sexuality and song, wishing for gold and other treasures will keep the mind always highly nervous and agitated leading to premature senility which shortens life and may result in incurable illness and premature death.

Second, it is recommended to ‘look but see not, listen but hear not’. To keep a sound mind, care must be taken to avoid harmful stimuli from the outside world that may have negative effect on the mind. Eyes and ears are the principle organs to receive outside stimulus and their functions are controlled and regulated by the mind. Man lives in society and what one hears and sees will inevitably reflect in the brain and exert influence on the mind. If the eyes and ears are kept away from worldly things the mind will be sound and quiet and the heart will not be impaired by over strain. Otherwise the mind will be troubled and the emotions will never be in tranquility. ‘Eyes greedy for sex can be likened to an axe cutting at life, ears intent on obscene music is like a drum beating to attack the heart’. It is advocated that restraining the eyes and censuring the ears, ‘seeing nothing and hearing nothing’ to keep the mind in a peaceful and quiet state. Though seemingly passive and impractical at first, keeping the mind in peace and quiet to a moderate degree lessens the harmful irritations of the outside world on the mind and is beneficial to mental as well as physical health. The great physician Sun Simiao wrote “the key to conservation for old aged lies in refraining from improper hearing, rash speech, irrational motion and preposterous thoughts”.

Third, concentration of the mind. To keep a sound mind it is not enough to maintain mental tranquility, it is also necessary to employ rationality, namely, to fix attention and concentrate the mind on one thing. When employing the mind, avoid putting it to more than one thing, otherwise attention will be diverted resulting in impairment and over strain. This of course refers to multitasking. Only through concentration of mind can we avoid mental stress in spite of employment because the attention is fixed and the mental activities are concentrated. Therefore keeping a clear and quiet mind requires not using it excessively, over thinking, not to involving it with selfish ideas and personal considerations. Using the mind so as to act without rashness can achieve a goal of keeping a sound mind. Moreover, as one lives in society, the mind will receive all kinds of stimuli, a state of absolute quietness is hard to accomplish. Accordingly, while keeping a clear and quiet mind, it is necessary to cultivate vitality in motion in conformity with the principle of tranquility being the foundation if motion and motion being the employed to stay tranquil. Concentration of attention in study and work can help keep a sound mind, dismissing desires for fame and wealth Sustenance of spirit after work or study in a skill, art, poetry, flowers, grass, and full of interest with fixed attention wards off disturbances and relieves mental unease. This is called the method of creating a state of tranquility in motion.

Cultivating ones mental faculties’ means; maintaining a positive state of mind, controlling the emotions to be in conformity with the changes of external stimuli in order to regulate mental activities. This is accomplished in the following ways.

Maintaining a gentle and pleasant temperament, maintaining high spirits and adopting an optimistic attitude toward life are accomplishments indispensable in life and an important factor in conserving health, preventing disease and prolonging life. Given a choice, cultivating temperament would be better than preserving health. One should foster noble ethics, ideals and values while refraining from anxiety, fury, sorrow, shock, and unnecessary talk and impatience in the satisfaction of desires. One should never nurse hatred. Even if something makes you angry, think which is more important, the issue or your health, in an instant the anger will be dispelled. Again, Master Sun stated, “life comes to man but once and the past will never come again, why not control the seven emotions and cultivate the temperament to protect you against disease?” Those who constantly keep the  mind at ease, the genuine qi in smooth flow and the blood in free circulation can prevent themselves from disease and live their full span of life The aged, in particular, should do something to get rid of the sense of old age and keep optimistic. A popular proverb states ‘laughter makes you ten years younger and distress causes your head to become grey’. ‘Anger speeds aging while laughter makes you young.  Li Ying, in the Song Dynasty was appointed head of the Supreme Court at the age of seventy but looked like a man in his forties or early fifties. When asked about his inspiration for health conservation he replied, “The only thing is that I never fret over anything. Even if I may go hungry tomorrow, I do not worry about it today. Whatever happens to me, I dismiss it and never take it to heart, and thus I always feel at ease”. It has been shown that most of the aged who enjoy longevity are broad minded and magnanimous, always cheerful, kind hearted and rarely depressed.

Yours in good health,

Robert Kienitz, DTCM

A Warrior’s Way

This blog is based on a letter I wrote to my sons on each of their eighteenth birthdays as they began their journeys into Manhood. I called it Manhood instead of adulthood because there is a distinct difference between being a male who is an adult and a male adult who is a Man.

I have broadened the terminology to include both (all) genders by borrowing from the lexicon of Don Juan Mateus and referring to those who have chosen to follow this path ‘warriors’. The warrior’s way is a way of integrity, the ‘war’ is the lifelong conflict we all face between behaving in accordance with a high personal ethical and moral standard and choosing a pattern of behavior, for whatever reasons, that is not.

There are far too many adults who have not taken the path of the warrior; you know them by their ethics, or rather, their lack thereof. Adults who do not behave well are highly visible in our society, to see them you only need to turn on the evening news and you will see adults embroiled in unethical business practices, coercive personal relationships and misuse of power.

People who have taken the path of the warrior are often less visible, in part, because the path of a warrior is often what one doesn’t do. But rather than have a conversation about what not to do, let’s talk about what a warrior does.

A warrior tells the truth. He keeps his promises. Honesty is part of his code of conduct. People can depend on him because they know he is honest in his personal and working relationships and, because people value honesty, they will tend to reward that with honesty back to him so he in turn can depend on them. This honesty builds community and leads to peace.

A warrior is true to family, leaders, friends and community. He is true to those above him as well as those below. He does not make preferences based on social order, wealth, power or fame.

A warrior is concerned about other people. He does things willingly for others without concern for pay or reward. This includes volunteering his time and effort to uplift and aid those in his community as well as those in his family. A warrior puts himself second in relations with others and, trite though it may sound, he knows that there is no ‘I’ in TEAM.

A warrior is a friend to all. He is a brother to all other people. He seeks to understand others. He respects those with ideas and customs other than his own. A warrior is blind to color and creed and untiringly seeks fairness, justice, equity and compassion for all other people.

A warrior is polite to everyone regardless of age or position. Good manners are social lubricant they make relationships of all kinds work better and run smoother. He never forgets his ‘yes Ma’am’s’ and ‘no Sir’s’.

A warrior understands there is strength in being gentle. He doesn’t use force or bravado to get what he wants. He engages in honest and fair negotiation and looks for win-win solutions to problems so that everyone walks away satisfied with the solution. He treats others as he wants to be treated, this is the golden rule taught by every philosophy and religion on the planet.

A warrior follows the rules of his family, community and society. He obeys the laws of his community and country. If he thinks these rules and laws are unfair, he works to have them changed in a fair and orderly manner rather than disobey them.

A warrior looks at the bright side of life. He cheerfully takes on tasks that come his way. He tries to help others to adopt the same optimistic attitude. This optimistic attitude is expressed in action and word, if he doesn’t have a positive way to express himself he holds his peace until he does.

A warrior works to pay his own way and to help others. He saves for unforeseen needs. He protects and conserves natural resources. He carefully uses time and property. He is generous when there is abundance and when there is want. He donates his skills and money to good causes that help the community, society, the environment and the world.

A warrior is brave and can face adversity even when he is afraid. He has the courage to stand for what he thinks is right regardless of the common opinion and he stands for those who are too weak or fearful to stand for themselves.

A warrior is reverent toward God, nature and his own spiritual nature. He is faithful in his spiritual cultivation and duties. He respects the beliefs of others. Even a person who does not believe in God or spirituality will adopt a way of life as though he did.

Sometimes the things that may or may not be true are the things a warrior needs to believe in the most. That people are basically good. That honor, courage and virtue mean everything. That power and money mean nothing. That good always triumphs over evil. That true love never dies. It doesn’t matter if they are true or not, a warrior should believe in those things, because those are the things worth believing in. And a warrior acts on what he believes in.

Yours in good health,

Robert Kienitz, DTCM

Subjective effects of Qi in acupuncture therapies

Many people experience subjective sensations during and after acupuncture type treatments (such as cupping, moxa, gua sha, electro and laser therapies) as well as qigong therapy. With  the Effects of qi are also the sensational effects that emerge from qi sensation felt by the practitioners, those who perform the above therapies and emit external waiqi to treat others and those patients respectively.

When qi dirigation (the power of controlling or modifying involuntary bodily functions, such as the pulse, temperature, or digestion) reaches a certain stage there appear effects of qi such as a ‘pressing and moving’ sensation. When a practitioner conducts qi by any means,  his body tends to have various sensations such as the phenomena of ‘eight touches’, i.e. pain, itching, cold, and warm, lightness, heaviness, astringency and slip. Other reported sensations are largeness, smallness, lightness, and heaviness, and cold, heat, itching and tingling. Of course there may appear still more subjective qi sensations in the process of qi therapy. These phenomena are all manifestations of the well trained skill and qi accomplishments of teh practitioner and the free circulation of qi in the channels and collaterals and the different forms of genuine qi moving inside the body. For example, when tranquilization is achieved in qi dirigation, genuine qi is circulated freely, the capillaries are expanding and various parts of the body have a filling and expanding sensation, the practitioner or patient may feel their body to be very tall and large. When qi enters from the outside to gather at Dantian (lower abdomen) the practitioner or patient may have the sensation of a very small body. When genuine qi sinks down in exhalation the body may feel heavy as a rock so solid that nothing can remove it. When genuine qi circulates through the heart and kidney, the kidney yang is sufficient, and the kidney fluids full, the body may have a comfortable sensation of pleasant cool. Whereas when genuine qi is vigorous and thermal qi is amassed the parts of the body which qi passes through may have a hot sensation. Itching of the skin and scalp is also an inevitable process, because the channel and minute collaterals are obstructed at ordinary times, once the genuine qi passes through the channels the parts of the body where it passes often have a creeping electrical sensation as the pathways open. These phenomena are all normal effects of qi dirigation which are active and conductive. There should be no alarm or panic if they occur and no curiosity and pursuit for them either. As long as qi dirigation is carried on peacefully and calmly the sensations will disappear spontaneously in a period of time.

At times there may be a hot sensation all over the body and slight perspiration especially at the abdomen and the four limbs may have a warm sensation. This phenomenon indicates that the functional activities of qi are brisk and active and genuine qi is gathering and accumulating. A slight perspiration is suitable but profuse sweating is contraindicated.

The freshness and vigor of spirit is usually correspondent with a tranquil state and can be sustained for considerable periods of time after the therapy.

Gastrointestinal peristalsis is accelerated while the appetite is whetted; it is not uncommon for practitioners to experience borborygmus (digestive noises) and increased appetite during therapy and both are indications of a strong central qi.

Itching of the skin, stirring of the muscles and joints manifest that the functional activities of qi in the body are vigorous and brisk. Such phenomena tend to be found at the terminus of the limbs and as a general rule these sensations can disappear naturally.

When qi dirigation reaches a certain stage there may appear flashing lights before the eyes like lightning or sometimes swaying back and forth like a neon light, sometimes piercing the brain glitteringly through the spinal column and sometimes appearing as a light ball rotating at high speed through the front and back mid-line of the body, usually for three circuits. These phenomena appear and disappear spontaneously. If a practitioner has achieved a great deal of accomplishment in qigong a light ball or light beam may exist constantly at the acupoint Bai hui (vertex of the head). The degree of light sensation and the colors of light may vary in accordance with the degree of the practitioner’s qi accomplishments.

When practicing acupuncture therapies or emitting qi, the achieved therapist can sense genuine qi and pathogenic qi inside of the body or at the region emitting external waiqi to diagnose and treat disease in accordance with these subjective qi sensations. The sensation of genuine qi is felt as slightly hot, or cool, tingling, oppressing or tugging sensations at the regions emitting waiqi. There can also be a sensation of the circulation, density, direction and amount of one’s own qi.

When a therapist emits waiqi towards the patient to treat diseases most patients produce some effects of qi such as a ‘radioactive’ sensation or the sense that the patient is being physically touched or the sensations that are felt in qi dirigation such as cold, hot, oppression, tugging, creeping, tingling, heaviness, lightness, floating, sinking or other sensations. This kind of effect of qi sensation results from the channel qi circulating and acting on the foci among which hot cold, tingling, etc sensations are the commonest.

When a therapist emits waiqi to treat diseases, involuntary dynamic phenomena can appear on the patient instantly or gradually in local parts of the limbs or the whole body. In some cases muscles slightly stir, while in other cases the limbs or body produce dramatic movements. This is the phenomena of waiqi inducing spontaneous movement.

Some patients, on receiving waiqi may experience photo-electrical phenomena, there may be electrical sensations on the limbs and on other cases light patterns can be seen in different forms, most of which present as round sheet or lightning patterns.

Some patients experience sounds or noises such as rustling rumbling and squeaking sounds while other patients experience specific kinds of smells and give various responses such as the sweet scent of sandalwood or the fragrances of flowers.

Among the above mentioned phenomena of effects the qi sensation is the most common, dynamic phenomenon. Some sensations are relatively rare and the others even more so. These subjective sensations are a result of personal sensitivity and some patients feel no effects of qi sensation whatsoever when receiving external qi treatment but still achieve very good therapeutic effect.

Yours in good health.

Robert Kienitz, DTCM


The wayfarer crossed the land searching for people who have lived beyond one hundred years. Those he found to be most vigorous were asked the key to their venerable age.

The first, twisting his long white beard said, “I neither drink alcohol nor smoke any substance”.

The second elder, smiling, replied, “I take a good hike after my meals”.

The third, nodding her wizened head answered, “I have always consumed little food and rarely eat meat”.

The fourth, with her staff in hand replied, “Instead of riding, I have always walked wherever I go”.

Elder number five, straightening his sleeves said, “I myself have always kept a garden for the labor of my body and peace of mind”.

The sixth ancient one, wearing a yin yang t-shirt, replied,”I practice Tai Chi and Qigong every morning”.

The seventh, rubbing his big nose, said. “I leave the windows of my home open to allow the fresh air in”.

Number eight, with a twinkle in her eye whispered, I retire early and rise early as the seasons allow”.

The ninth senior, caressing her tanned cheeks said, “I sunbathe every day that is not cloudy to nourish my skin and bones”.

The tenth of them responded with a chuckle and a smile, “I always keep myself free from worries”.

So the secrets of these people, who together have lived for over a thousand years, will surely guide us all to long and happy lives.

Yours in good health,

Robert Kienitz, DTCM

Laser Acupuncture…

Since ancient times, people believed that rays of light could carry magnificent and mysterious powers and we have been in a search for those powers even to modern times. 

Interest in radiation (rays of light) increased around the start of the 20th century with the discovery of radio, X-rays and radioactivity. The term “laser” originated as an acronym for “Light Amplification by Stimulated Emission of Radiation”. The first laser was built in 1960 by Theodore H. Maiman at Hughes Research Laboratories.

 When first discovered, the laser gave rise to many fantastic hopes and was heralded as an answer to many of the world’s problems. Lasers would be used to melt dangerous icebergs, replace the existing telephone networks or carry millions of volts of electricity from one place to another. Leaving aside some of the more far-fetched (or premature in the case of telecommunications) applications, by 1965 people envisaged using lasers as scalpels in surgical operations, minimizing skin scarring, helping wounds heal faster and affecting cellular metabolism. It was hoped that Laser would help facilitate nuclear fission, be used as a precision measuring device and cutting tool for metals or as a means to store information (CDs) or to produce 3D images (holography).

In the 1970s serious research began in China, Russia and the US and by the 1980s, due to numerous positive reports, laser started to gain recognition as an effective method of stimulating acupuncture points without the use of needles.

Today, photobiology is the study of how light affects living things, and includes studies of single-celled organisms, plants, animals and humans. Laser acupuncture is an important field of study within photobiology.

Lasers used in acupuncture are known as low-intensity or “cold lasers,” because they don’t produce heat. These are not the same as “hot lasers” used for surgery, which are used as a scalpel to cauterize or cut. Studies show that low-intensity lasers can help regenerate cells, decrease pain, reduce inflammation, improve circulation, and stimulate tissue regeneration and growth.

In 2003, at the National University in Seoul, Korea studies were undertaken that that addressed laser acupuncture and meridian theory. Researchers shined laser light on acupoints on limbs of the body and found that the laser light traveled subcutaneously to other related acupuncture points along regular meridian pathways. The light did not travel to places on the limbs that were not associated with acupuncture meridians. It appeared that the body contains a sort of fiber optic network—where light enters an acupuncture point, travels through the meridian and was detected at other places along the meridian with sensitive photon detectors. This study shows how light energy may actually be received and transmitted throughout the body. Additionally the study proved the existence of the acupuncture meridian network.

Recent studies on laser acupuncture have also included advanced brain imaging, as well as several other modern protocols for measuring various physiological effects to the body. These studies show that laser acupuncture has physiological effects, not only locally, but also in the brain, similar to needle acupuncture.

Scores of random clinical trial studies published in Chinese, North American, Russian and European journals over the last 30 years have concluded that the use of laser light can be used as an alternative to needles.  Evidence was found supporting the use of laser acupuncture in the treatment of myofascial pain, postoperative nausea and vomiting and for the relief of chronic tension headaches and many other conditions. Laser acupuncture represents an effective form of acupuncture for the management of these conditions and should be considered as a viable adjunct or alternative to more traditional forms of acupuncture point stimulation. As more studies are done the database of conditions treated with Laser therapy will undoubtedly grow.

Traditional Chinese medicine has used moxabustion as a source of radiant heat therapy on acupoints for millennia so the transition from moxa to laser is not a big leap clinically. The light emitted from a red, low-intensity (635nm wavelength) laser corresponds to the glow of the moxa stick and is in fact also seen as being a yang, stimulating type of therapy. Laser light, in Chinese medicine, is used to break through stagnant qi which is one source of all pain and illness. Laser light also nourishes vacuous qi at the applied acupoint, qi deficiency being the other source of all pain and illness. Laser light is one of only two methods of directly introducing yang energy into the body, the other method being electro-acupuncture.

Laser therapy is completely pain free and can be used on up to fifteen points per session with each point being activated for 20 – 30 seconds each time for up to three repetitions. The Laser treatments are advised two to three times per week for the duration of the course of treatment. Laser therapy can also be used in conjunction with auricular (ear) acupuncture and standard body acupuncture in which cases the ear beads or needles are directly stimulated by the laser light.

Yours in good health,

Robert Kienitz, DTCM

Medical Marijuana and TCM II

One of the complications facing clinical practitioners in Florida is that for the past couple of years, the state has allowed the use of so called Medical Marijuana and Cannabis. Since the law went into effect, dispensaries have cropped up in every city and town and I am informed by a patient that acquiring a prescription for MM from an MD affiliated with a dispensary is as easy as showing up and signing a few forms. None of the patients I have met have been prescribed MM had a physical exam by the dispensing physician and there is no follow up unless the patient requests one. The non medical dispensary operators are given carte blanche to suggest dosage and delivery mechanisms and some patients who have expressed concerns about addiction and other negative side effects have been told that MM “works for everyone” and that there are “absolutely no negative side effects, ever”.

Because marijuana is currently classified by the US federal government as Schedule I, “a drug with no medical use”, studies that discuss medical marijuana are limited in both number and scope. Many studies compare smoking habits and respiratory distress among cigarette and cannabis smokers, as well as symptoms of abuse and addiction in recreational users, but few address the side effects of medical marijuana.

One study in Canada described the most common side effects of cannabis use in patients with non-chronic cancer pain as “cognitive side effects” and dry mouth. In the United States, nabilone may produce similar “cognitive side effects” or psychiatric symptoms, hypo and hypertension, and tachycardia if the prescribed dosage is too high. Dronabinol has also been associated with a “cognitive side effects,” sleepiness, or withdrawal symptoms lasting up to 48 hours that appeared in only one study, which promptly stopped dispensing the medication. The categorization of cannabis as Schedule I, therefore, is a double-edged sword: because few clinical trials have been run, few negative side effects have been reported.

Effect of cannabis use in people with chronic non-cancer pain prescribed opioids: findings from a 4-year prospective cohort study

 ~ The Lancet, British Medical Journal, July 2018

In conclusion, cannabis use is common in people with chronic non-cancer pain who have been prescribed opioids, and interest in medicinal use of cannabis is increasing. We found no evidence that cannabis use improved patient outcomes; those who used cannabis had greater pain and lower self-efficacy in managing pain. Furthermore, we found no evidence that cannabis use reduced pain interference or exerted an opioid-sparing effect. ~

Medical marijuana: Do the benefits outweigh the risks?

 ~ Current Psychiatry · January 2018

There is no clear and convincing evidence MM is beneficial for psychiatric disorders, and Cannabis can impair cognition and attention and may precipitate psychosis. The risks of deleterious effects are greater in adolescents. Cannabis use causes impairment of learn­ing, memory, attention, and working mem­ory. Adolescents are particularly vulnerable to the effects of Cannabis on brain develop­ment at a time when synaptic pruning and increased myelination occur. Normal brain development could be disrupted. Some studies have linked Cannabis use to abnor­malities in the amygdala, hippocampus, frontal lobe, and cerebellum. From 1995 to 2014, the potency of Cannabis (THC concen­tration) increased from 4% to 12%.58 this has substantial implications for increased abuse among adolescents and the deleteri­ous effects of Cannabis on the brain.

Heavy Cannabis use impairs motivation and could precipitate psychosis in vulnera­ble individuals. Cannabis use may be linked to the development of schizophrenia.59

There are no well-conducted Randomized Controlled Trails on the efficacy of MM, and adequate safety data are lacking. There is also lack of con­sensus among qualified experts. There is soft evidence that MM may be helpful in some medical conditions, including but not limited to CINV, neuropathic pain, epi­lepsy, and MS-related spasticity. Currently, the benefits of using MM do not appear to outweigh the risks. ~

Cannabis for Chronic Pain: Not Ready for Prime Time

  ~ American Journal of Public Health January 2019

The use of cannabis (particularly its principal psychoactive constituent, Δ tetrahydrocannabinol or THC) is associated with health risks including lung disease (when smoked), cardiovascular disease, acute pancreatitis, and cannabinoid hyperemesis syndrome. Cannabis users are also at increased risk for occupational injuries, and cannabis-associated “drugged driving”, sometimes fatal, is increasing. Cannabis use during pregnancy has been associated with increased neonatal morbidity or death.Finally, the myth that marijuana is non-addictive has been dispelled by studies of forced abrupt cessation of use indicating potential rebound hyperalgesia and craving. As the health risks associated with cannabis come under increasing scrutiny.

Diminution of gray matter in the brain in chronic cannabis users has long been recognized. Empirically established deficits following months to years of use involve—but are not limited to—executive functioning, information retrieval, learning, abstraction, motor skills, and verbal abilities, with use of higher-THC cannabis resulting in more profound deficits. Psychopathological consequences of cannabis use include acute psychosis, schizophrenia, worsened social functioning in schizophrenia, bipolar disorder, depression, and anxiety (particularly with increasingly common high-sativa content strains).

Objective data on the efficacy of cannabis for pain management are not particularly encouraging.Cannabis can be helpful in relieving neuropathic pain, with the magnitude of analgesia generally contingent on the amount of THC. Unfortunately, higher-THC cannabis, similar to opioids, also produces more cognitive side effects, often rendering patients impaired at work and in activities of daily living. Moreover, much of the earlier clinical trial literature on cannabis for neuropathic pain has been rendered obsolete.

Unfortunately, it remains extremely difficult to conduct clinically relevant medical cannabis research in the United States because of the drug’s Schedule I status, and the requirement that all cannabis used be obtained from a single farm at the University of Mississippi, and it is permitted to grow only 1000 pounds of cannabis for research purposes each year. Even more problematic is that until very recently, the University of Mississippi was permitted to cultivate cannabis with a maximum THC content of 7%, yet 67% of medical cannabis consumers choose to use oils and other concentrates with THC contents as high as 90%. Cannabis for investigation with a higher THC content (13.4%) was obtainable only recently from the National Institute on Drug Abuse (NIDA). Thus, research on the analgesic efficacy of what the DEA considers “strong marijuana” has been flawed.

Adding to these reservations concerning cannabis as an analgesic is that THC is not the most medically relevant constituent of cannabis. Cannabidiol (CBD) is a noneuphoriant cannabinoid with a good safety profile and has activity as both an analgesic and anti-inflammatory. Importantly, CBD modulates the euphoria produced by THC and provides mild anxiolysis. Although it is thought that cannabis contained equal amounts of THC and CBD in pre-agricultural times, when the plant grew wild, users’ and hence growers’ desire to maximize THC content for its euphoric effects has resulted in CBD being all but bred out of the vast majority of cultivated cannabis. Efforts to find cannabis that contains low concentrations of THC and high levels of CBD in dispensaries are often futile. Furthermore, the CBD that is found in common hemp (the most widely used source for commercial non medical CBD oil) is virtually nonexistent.

Few if any health care providers who authorize medical cannabis educate their patients specifically to seek the most “medicinal” forms of the drug. Even if this aspect of sourcing a uniform, well-characterized supply of cannabis for research or clinical purposes were overcome, another fundamental challenge for such studies is that (unlike for morphine or other opioids) blood levels of these agents do not consistently correlate with their in vivo effects. ~

In the last Blog we learned that traditional Chinese medicine and Chinese medical psychiatry do not condone the use of the use of medical cannabis or marijuana for indications of pain management, addiction withdrawal, constipation and lack of appetite does not advise its use given the historical understanding and the negative side effects involved.

In the light of the unsettling safety profile of cannabis, the lack of strong empirical support for its efficacy, the general absence of CBD in what is used “medically,” and the methodological challenges in conducting research suggest that, at present, cannabis should not necessarily be considered an optimal choice as a drug for pain management.

Yours in good health,

Robert Kienitz, DTCM

Medical Marijuana and TCM

One of the more frequently asked questions I am asked is “what is Chinese medicine’s take on the use of medical cannabis or marijuana?” Over the course of the next few blogs I will share my thoughts on the subject and will begin with the Chinese medical understanding of the drugs.

Cannabis sativa or Hou ma jen was one of three hundred and sixty five herbs, animal parts and mineralsoriginally listed in theDivine Farmer’s Materia Medica” (Shen Nong Ben Cao). The Ben Cao is one of Chinese medicines oldest books and was cited by authors and scholars as early as the Qin Dynasty period around 221 BCE. Even by then however, the original manuscripts had been lost to history. In the Materia Medica the plant part of particular interest of cannabis sativa was the seed and it was listed as a “superior class cereal”.

The cannabis seed or Huo ma ren has a sweet and balanced nature, enters the spleen, stomach and large intestine, supplements the “center” and boosts the qi. Prolonged consumption of the seed may “make one fat (a good thing in ancient China), strong and never senile”. Contraindications are that overconsumption causes dizziness and vertigo. With women there was also a contraindication during pregnancy.

Hemp seeds are still widely used as medicine in both China and the west, they function to dredge wind, relax the spleen, moisten dryness, promote lactation and hasten delivery, disinhibit urination and defecation. We use them mostly for their effect of moistening the intestines to unblock the bowels and are the go to herb for any kind of constipation.

Cannabis seeds, like other herbs in the Moist Laxative category are various seeds and nuts. The major known ingredients in the seeds are unsaturated fats in the form of lipids and, what little cannabinol is in the seeds is inconsequential, and the seeds are processed so that they cannot germinate and are thus not a controlled substance. Having said that, the sesame seed Hu ma ren is as effective as cannabis seed in this capacity and has none of the stigma of being related to a schedule I drug.

The leafy and flowering or folium and flos parts of Hou Ma Jen are acrid, windy and balanced in nature and mainly treated the “seven damages” which are injuries to the spleen, liver, kidneys, lungs, heart, ‘storms and extreme climate’ injuries of the body, and ‘fear and indulgence’ injury to the will. Hou Ma Jen also disinhibited the five viscera, i.e. heart, spleen, lung, kidney and liver.  

Hou Ma Jen precipitated blood and cold qi but are cautioned that consuming too much of the folium causes one to ‘behold ghosts and frenetically run about’. Protracted consumption of the folium may also encourage one to ‘communicate with spirits’.

Due to the mind altering properties of Cannabis, the leaves, buds and flowers were not used much at all mostly because there were many other plant medicines to choose from with the same positive effects but none of the negative side effects. It is interesting to note that in ancient China, cannabis, when used at all, was taken as a liquid decoction or tea and never smoked.

From the point of view of Chinese Medical Psychiatry, the use of cannabis generally elicits one of two responses. In the first case many people experience a pleasant euphoria and sense of relaxation. Other common effects in this first scenario, which may vary dramatically among different people, include heightened sensory perception (e.g., brighter colors), laughter, altered perception of time, and increased appetite.

The euphoria and relaxation are due to the movement of qi via coursing the liver, changes in the intensity of light and color are the eyes responding to the relaxing quality of the drug on the liver. Laughter and giddiness are the typical response to the free flow of qi of the heart and the increased appetite is due to the unrestrained liver harmonizing and rectifying the spleen and stomach.

All of the above responses indicate an underlying mild condition of liver qi stagnation and some degree of spleen qi vacuity. Cannabis clearly helps alleviate these two conditions but only for a short period of time, 1-3 hours. Because the effects are short lived we can conclude two things, one is that cannabis is not an appropriate drug for liver qi stagnation because it does nothing to fortify the qi while releasing constrain. And that over consumption will eventually result in qi vacuity which will cause greater qi constraint and the drug will have to be taken more frequently and or at greater strength to achieve the same euphoric effect.

The above is one of the definitions of addiction, and with this understanding there is no relevant argument for cannabis being non-addictive.

Pleasant experiences with marijuana are by no means universal. Instead of relaxation and euphoria, many people experience anxiety, fear, distrust, or panic. People who have taken large doses of marijuana may experience an acute psychosis, which includes hallucinations, delusions, and a loss of the sense of personal identity. These unpleasant but temporary reactions are distinct from longer-lasting psychotic disorders, such as schizophrenia, that may be associated with the use of marijuana in vulnerable individuals.

This second scenario occurs in people who are already suffering from, for instance, heart timidity and gall bladder qi vacuity. The consumption of qi through the action of the acrid natured cannabis quickly lowers the resources of the already depleted heart qi and gall bladder meridians and organ systems which are very susceptible to acrid herbs. The consumption of qi and blood through cannabis use can affect other organ system conditions as well such as; spleen qi vacuity, spleen qi and heart blood vacuity, liver qi stagnation with blood vacuity and about twenty other commonly seen conditions.

Persons with any of those conditions are considered vulnerable and are at risk, over time and prolonged use, to longer lasting psychotic disorders.

As with the primary scenario, the substance is addictive by nature so the probability and risk factor is increased.

So, from a traditional Chinese medical and psychiatric perspective, the use of medical cannabis or marijuana for indications of pain management, addiction withdrawal, constipation and lack of appetite is not advised given the historical understanding and the negative side effects involved.

Next time I will explore conventional medical science regarding medicinal marijuana and cannabis.

Yours in good health,

Robert Kienitz, DTCM

Lunar New Year…

Nearly everyone is familiar with the animal symbolism associated with Chinese astrology and in particular about the association with the Chinese New Year. The Chinese New Year is actually the Asian Lunar New year which always falls on the second new moon after the Winter Solstice. The Lunar year is divided into twelve lunar cycles from absolute new or empty moon to the next. The zodiac animal symbols are representations of the progression of the twelve year energy cycle and are indicative of the nature of the individual Zodiac animal nature. The relative Yin or Yang nature of the animals themselves is one of the most debated aspects of Asian astrology.

The animal symbols for the zodiac cycle came to China from India about the same time as Buddhism during the first century CE. Buddhism contains certain sutras that mention the animal relationships to the year cycles. The ancient Chinese loved to incorporate, and as with all things, the Chinese incorporated the animals into their already very sophisticated astrological perspectives that were until that time solely based on the principles of the I Ching

In Chinese cosmology, the Chinese Zodiac follows a twelve year progression and the day is also divided into 12 time divisions with each division corresponding to two hours of a twenty four hour day. During each two hour time division one of the twelve organ systems is in a relative state of repletion while its opposite organ (on the Chinese clock) is in relative vacuity. As time passes, the Qi of the organs and their respective channels ebb and flow like the tides of the ocean. This is not to be confused with the concept of repletion and vacuity as pathological responses or factors of disease, this is a natural ebb and flow and, like the seas, the organs and channels at low tide are not pathologically empty any more than they are pathologically full at high tide. The I Ching tells us that this is the way of all things, that there is a constant ebb and flow of the energies and events of the universe, the I Ching demonstrates those energetic changes in the movement of the lines of the sixty four hexagrams in general and the twelve Tidal Gua in particular.

In the system of Chrono-acupuncture, Zi Wu means literally midday-midnight but more broadly is interpreted as ebb and flow. The Tidal Balance System of Acupuncture, developed and refined by Robert Kienitz, uses the relationships between the ebb and flow of Qi and blood in the human body and the ebb and flow of the heavens, earth and sea.

Within the I Ching there are many wave form cycles of change represented. Some wave forms are short and some are as long as the flow of the sixty four hexagrams in their entirety. The wave form that the Tidal Balance Method of Acupuncture uses is a series of hexagrams that create a wave form that corresponds to the wave forms of the natural cycles of lunar and annual solar change.

The I Ching tells us that the days, months and seasons of the year progress in an orderly flow of energy from greatest yang to greatest yin and back again. The hexagrams representing this flow of energy are referred to as Tidal Gua.

The Tidal Gua energy signatures represent any linear or temporal, series of events. The Tidal Gua can be used to balance any conditions that arise from time related phenomena or that reoccur consistently in the same time cycle. This is true for hours in a day, days in a lunar month, months in a year and years in a Zodiacal cycle. One of the best examples of this is the correspondence of a woman’s menstrual cycle to the lunar phases each month. The changes in hormonal and other physiological relationships can be easily modified and harmonized by using the Tidal Balance Acupuncture Method.

Robert Kienitz has drawn on his decades study of Acupuncture and Oriental Medicine and his lifelong study of the I Ching to develop the Tidal Gua and their relationship to acupuncture and Asian medicine.

Yours in good health,

Robert Kienitz, DTCM

Return to Spring…

If you travel to the Far East, especially China, Taiwan, Macao and Hong Kong you will invariably come across traditional herbal pharmacies. The oldest continuously operating pharmacy in China is the Tong ren tang which opened in 1669. The current establishment is on a side street of Qian men Avenue south of the Square of Heavenly Peace.

The names of Chinese pharmacies frequently contain allusions to the basic values of Buddhism and Confucian ethics so Tong ren tang translates to ”pharmacy of partaking in human virtue”. Other examples of names for traditional pharmacies are shen de tang “pharmacy of attention to virtue”, zhi de tang “pharmacy of utmost virtue” or ren de tang “pharmacy of human virtue”. The character tang has the meaning “pharmacy” in these contexts.

Other pharmacy names point out the goals of the medicines produced by the business like yong shen “eternal abundance”, bao yuan “preserving the original qi”, yi shou “benefiting longevity”, shou kang “longevity and health”, wan quán “myriad healing” and bao zi “protection and restoration”.

The figurative term “spring” meaning “health” also appears on many pharmacy names as hui chun “return to spring”. The variations on the term crop up so often that pharmacies are colloquially referred to as hui chun tang even when the pharmacy has another name or it may be known by the owners name as in hui chun Hua Tuo tang literally “Hua Tuo’s return to spring pharmacy”. It is also common to drop the character for “pharmacy” and simply have a sign in front of the store declaring Hui Chen “return to spring” which everyone knows refers to a traditional pharmacy.

The lack of trademark concerns in the East make the use of the term “return to spring” ubiquitous so many pharmacies will tout their lineage to show that they were established several generations past by famous doctors. Even this is an uncertain proposition for an unfamiliar person because many stores will usurp the famous name and while navigating a street you may see several stores proclaiming hui chen Hua Tuo Laodian “Hua Tuo’s original establishment”.

The Chinese pharmacy has several functions for their clientele, obviously the preparation of herbal medicines as prescribed by Chinese traditional doctors for their patients is foremost, but many pharmacies also have an onsite doctor so that a person can go in, have their pulse and tongue examined and be prescribed an herbal medicine on the spot. The herbal medicines vary from loose raw herbs that are taken home, boiled and drunk to pills, capsules, boluses and many other configurations of individually prescribed medicinal formulas.

The pharmacies also have their own brand of so called patent medicines that are good for anyone who wants to “return to spring” and maintain good health, these are over the counter medications without need for a prescription. These medicines are typically tonic formulas, that is, medicines that tone up or supplement specific organ functions and tissues. High on the list of this type of medicine are digestive formulas to improve nutritional intake, generally referred to as spleen tonics, medicines that improve the function of the kidneys and to promote sexuality and longevity, tonics for improved brain function and cognition called scholars tonics and medicines for calming the mind and improving sleep.

Atlantic Acupuncture has its own line of “return to spring” medicinals that are great supplements for any-body. Jian Fei Tang is our signature digestive formula to improve nutritional intake as a spleen tonic. Strength & Stamina is our medicine that improves the function of the kidneys and promotes sexuality and longevity. Brain Food is our scholar tonic promoting memory and cognition and Peace & Sleep calms the mind and improves sleep.

These four tonic formulas are available here on our online store. We urge you join the many others who have tried our formulas and felt the wonderful return to spring!

Yours in good health,

Robert Kienitz, DTCM