Summer-Heat: Chinese Medicine and Seasonal Exposure

Exposure to the elements can be a significant contributing factor in illness and imbalance, but isn't one we often think about in modern times because we are indoors so much. Most of us are outdoors just minutes per day as we move between our car and various buildings with controlled environments. Air conditioning, central heating, and devices that control humidity help us modify our interior spaces, significantly neutralizing extremes in temperature and moisture. While inside we are also protected from major weather events like blizzards and hurricanes. During earlier times in human history, however, we spent much more time outdoors, and protecting ourselves from exposure was a daily concern. It is during this time that Chinese medicine was developed, so there is more of an understanding in this field about how environmental factors can contribute to illness and disease.

Summer-heat is a seasonal condition that is caused by exposure to excessive heat and humidity. In western medicine this condition is called heat-exhaustion or, if more severe, heat-stroke. We are particularly susceptible to this and other types of exposure in modern times for three main reasons. One is that we spend so much time in controlled environments that we are actually less acclimated to the outdoors. Our bodies just aren't as practiced at neutralizing the effects of the elements, whatever they are. Another reason is that we don't know to prepare. For our ancestors, exposure was a real concern and they were faced with it on a much more regular basis. We, on the other hand, have become spoiled by easy access to artificial environments and can easily escape. Thinking about exposure is usually outside the scope of our day-to-day consciousness so we are less likely to do the things we need to do to protect ourselves. The third reason is that we have lost a lot of the general collective knowledge and awareness of what the early symptoms of exposure are so we are less likely to see the warning signs. Unless you were in the scouts or are trained in first aid, odds are you just don't know.

Summer-heat affects our bodies by causing them to overheat and dry out. The first signs of overheating are sweating and clammy, pale skin as our bodies attempt to release excess heat to help regulate our internal temperature. The heat makes our mouths dry and increases our thirst, causing us to crave the cooling fluids that we need. As our bodies dehydrate our blood volume actually decreases, leading to low blood pressure. Low blood pressure plus low blood volume means headaches and dizziness because we literally lack enough blood to nourish the uppermost reaches of our bodies. The effort to eliminate extreme amounts of heat through copious sweating saps our energy, causing fatigue and physical weakness. If a person with these symptoms does not rest, drink fluids, and remove themselves from the sun and heat, the condition may progress to the next level: poor appetite, nausea, vomiting, diarrhea, and dark urine. Though rare, this condition can even become so extreme that it is life-threatening.

The best treatment for summer-heat is prevention: dress lightly when it is hot out, don't exercise in the late afternoon when the temperature peaks, avoid extremes of heat and sun, and and stay hydrated. If you or someone you know starts to have early symptoms of summer-heat, lie them down in a cool and dark place and give them plenty of fluids. Fluids that contain electrolytes, like coconut water or sports drinks, are best at replacing both the water and salts that are lost to sweating. If symptoms progress to the next level, medical attention may be necessary. In western medicine the most common treatment would be re-hydration with fluids and electrolytes through an IV drip. In Chinese medicine acupuncture and herbs are used to reduce internal heat, promote moisture in the body, and give relief from symptoms like nausea, vomiting, and diarrhea.

Traditional southern remedies like iced honeysuckle flower tea re-hydrate us and cool us from the inside out. In Chinese medicine honeysuckle flower is considered to be so effective an herb for eliminating heat from the body that it is prescribed not just for summer-heat, but also for fevers, sore throats, inflamed sores, intestinal abscesses, and infectious dysentery. Watermelon is another important Chinese herb for summer-heat. The sugars in this fruit boost energy and the juiciness replenishes fluids. Watermelon is also loaded with electrolytes, especially the pulp that is closest to the rind, and promotes urination. This combination stimulates the urinary system to eliminate heat from the interior of the body out via the kidneys and bladder. Stay cool!

Winds of Change: A Chinese Medicine Understanding of Airborne Disease

In Chinese medicine there are just a handful of categories into which every type of disease can be sorted. Some are very easy to understand, like Heat. This category includes diseases with symptoms such as fever, inflammation, infection, hot flashes, and night sweats. Another is Cold, which includes chills, frostbite, pain where the tissue is cold to the touch and improved with the application of heat, and diseases where there is an under-functioning system, like low metabolism, hypothyroidism, and certain types of infertility.

One of the other categories is Wind, which is not as easy to grasp and includes many seemingly unrelated conditions. To understand Wind as a metaphor for disease it is helpful to look outside to the wind itself and observe its characteristic behaviors: it comes on quickly, changes rapidly, travels fast, and causes movement, blowing the trees around and pushing the clouds across the sky. Wind conditions have these same characteristics. For example, since strokes come on so rapidly, cause immediate and dramatic change, and are accompanied by spasmodic movements, they are categorized as Wind. Other examples of Wind include tremors, epilepsy, and even itchy skin conditions like eczema and hives.

Interestingly, respiratory diseases caused by airborne pathogens are also categorized as Wind. I find this especially amazing considering that Chinese medicine predates the invention of microscopes and the germ theory of disease by thousands of years. Still, the ancient Chinese were able to understand that certain symptoms were related to something carried by the wind. They couldn't see it directly but they knew the pathogen was there by its effects. Think about it; just like the Wind diseases above, symptoms of airborne viruses come on fast, change quickly, sometimes even by the hour, spread rapidly from person to person, and cause movements like shivering, chills, or even the convulsions that come with dangerously high fevers.

Since COVID-19 I've been thinking a lot about Wind. This airborne disease in particular has come on so fast and spread so quickly, traveling around the entire world in just in a matter of months. Because of its speed and far-reaching scope I think this disease is behaving a lot like the Black Death and other historically significant diseases before it, resulting in rapid social change. Since the pandemic, it seems like we are all pausing and reflecting, reevaluating everything from how we socialize and communicate to how we work and travel. Even mundane tasks like going to the grocery store or getting gas have taken on a whole new meaning. It is clear that our society at large is going through some sort of major shift or transformation and COVID-19 is accelerating the process. I don't know where we are heading but I sincerely hope that all of this reevaluation and reflection brings about a lot of positive changes.

My Ode to You

The study of medicine, ultimately, is the study of humanity. I feel very fortunate that my line of work requires me to meet so many new people on a regular basis. You, as in the collective you, have taught me many things, not just about medicine but about what it means to be human. You have my sincere admiration and gratitude. This is my ode to you!

• You are Unique - I have never met anyone who is a "textbook case" and I am certain that I never will - it simply is not possible! Like each one of the thousands of flowers in a spring meadow, you are rare and unique and it is so lovely to have made your acquaintance.
• You Care - You care about your health, for that is how I know you. You also care deeply about your friends and family, and want them to be happy and prosperous. You care about your pets, furry, feathered, or otherwise. You care about humanity and you care about our shared home, planet earth.
• You Hold the Power of Transformation Within You - It is amazing to see how you shift and change over time. You process thought transition, balance out, get well, move on, loose weight, draw boundaries, overcome obstacles, re-focus, recharge, decompress, regain your strength, and so much more. Do not forget that you are always and forever in the process of transformation and that you can tap this inner power at any time.
• You are Positive - It is true what they say, that everybody's got troubles. However, even in the toughest of times you hold you ground, believing that there are better days ahead. Even in the most difficult of situations, you can see the good that comes from it. In truth, your power of positive thinking has inspired me many times and I thank you for that.
• You Live with Intention - You try so hard to do good, to make a positive mark on the world, to make a difference in the lives of others less fortunate than yourself. You live with great purpose and intention and admire you for that. I aim to follow your example.
• You are Wise - You have taught me so much - thank you. From you I have learned a million things about the practice of medicine. From you I have learned a million things about what it means to be a good person, to be human. You have enriched and enlightened my life. This is my ode to you.

Why We Need the Sun

Over the past few days many of you have mentioned just how much you are effected by the rain and overcast skies. You have related how tired, depressed, and unmotivated you felt with all the low pressure and darkness. This really comes as no surprise since we literally need the sun!

Exposure to sunlight accounts for over 90% of the vitamin D produced by most individuals. Vitamin D not only improves immunity, strengthens bones, and protects against high blood pressure and Alzheimer's, it also boosts the production of serotonin, a neurotransmitter that regulates mood. In fact, many common anti-depressants work by artificially elevating levels of serotonin, including Selective Serotonin Reuptake inhibitors (SSRIs) like Celexa, Lexapro, Luvox, Paxil, Prozac, and Zoloft. Parkinson's disease is another condition where serotonin levels are low and recent research has shown that vitamin D can be a helpful supplement. To keep our vitamin D at optimal levels it is recommended that we receive at least ten to fifteen minutes of sunlight per day and eat a diet rich in foods that contain Vitamin D like fish, eggs, cheese, milk, yoghurt, and mushrooms.

Of course, Chinese medicine has a slightly different understanding of why we need the sun. In this system we need a balance of both yin and yang, two general categories into which everything can be organized. Yang is represented by the sun, warmth, and light, and correlates with activity. Yin is represented by the moon, cold, and darkness, and correlates with rest. For ideal health we must have a balance of these two opposing energies. If we don't have enough yang we will be tired, depressed, and unmotivated but if we have too much we will have mania, insomnia, and burnout. Since most of us spend so much time indoors and inactive, especially during these days of COVID-19, the positive effects of being outside in the fresh air and sunshine at this time cannot be understated. In Chinese medicine being outside immersed in the natural elements is even more beneficial. This is akin to the Japanese concept of "shinrin-yoku," or nature therapy, and comes with a host of added benefits including reducing stress and high blood pressure, accelerating recovery from illness, improving mood, and boosting immunity .