I really like when I can use a standard protocol for a disease and receive consistently good results. This is especially true when it is a condition such as rheumatoid arthritis, an autoimmune condition. Specifically, “autoimmune disease” refers to a condition where the body mistakes its own tissues for foreign invaders such as bacteria and viruses and creates antibodies to seek out and destroy those specific tissues. In the case of rheumatoid arthritis, the body attacks its own synovial tissues within the joints.

Besides being an autoimmune disease, rheumatoid arthritis differs from the more common osteoarthritis in terms of cause. Where rheumatoid arthritis is characterized by redness, swelling and eventual crippled joints and may affect all tissues of the body including soft tissues, osteoarthritis is caused by wear and tear of the joints that occurs in most animals as a somewhat normal course of aging.

At the onset RA might first affect the small joints of the fingers and toes with symptoms of warm, redness, stiffness, and swelling in these joints.  Eventually this can spread to larger joints including hips, shoulders and knees with occasional periods of remission. RA can damage the joints within three to six months of onset and individuals with RA may be unable to work after 10 years. Furthermore, it can affect other tissues including theheart, lungs, vascular system, eyes, skin and blood. All of these further complicate diagnosis. Western medicine has no cure for RA.

There is a standard blood test for used to diagnose rheumatoid arthritis.[1] Personally, I don’t refer to the RA factor blood test in my practice to treat a condition such as RA because traditional herbal medicine doesn’t require such a test. Furthermore, sometimes such tests applied to incurable diseases such as RA deepen a commitment in the patient’s mind to having a condition which from the body-mind perspective only makes rallying the complete healing forces of the body more difficult. Additionally, the RA factor test is unreliable; it can test positive in normal people and negative if there are other autoimmune conditions active in your body such as Sjogren’s disease, lupus, and viral hepatitis. Finally, I have treated many people who tested positive for RA successfully, provided the condition is not so advanced as to exhibit severe bone degeneration with twisted, crippled joints. In all cases, significant pain relief can be consistently achieved with the adoption of an anti-inflammatory diet and nature’s wonderful healing herbs.

It is estimated that approximately 41 out of 100,000 are diagnosed with RA per year and 1.3 million American have been diagnosed with it. The risk is somewhat higher for women and begins earlier in life than for men. Heart attack and stroke risk increases as much as 60% one year after diagnosis, people with RA are more liable to infections, and twice as likely to suffer from depression.

Drugs used to relieve symptoms are among the worst in terms of short- and long-term adverse effects. Drugs used in the treatment of RA include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), which are the mildest pharmaceutical treatment option. They range from aspirin to many others including ibuprofen. These help to reduce inflammation but do not halt the progression of the disease.
  • The next in line are corticosteroids, which quickly reduce inflammation and are supposed to be limited to short-term usage.
  • The next group of drugs are classified as disease-modifying antirheumatic drugs (DMARDs) which work to slow down the progression of RA and biologic DMARDs which are often used in combination to increase the efficacy of DMARDs.

Conventional medicine is beginning to acknowledge that dietary changes, lifestyle changes and herbs can relieve RA symptoms. My own clinical experience concurs with this.

There are few serious diseases that I can say seem to respond to a basic treatment protocol. However, so many patients who have come to me diagnosed with RA and osteoarthritis have responded positively to essentially the same basic protocol, which I share with you below.

Adopt an anti-inflammatory diet which consists of eliminating all refined white sugar, refined flour products, dairy, alcohol, and coffee. For some this may include gluten as well as other possible allergenic foods. Instead one should adopt a fiber-rich diet of organic fruits and vegetables, animal products such as naturally and organically raised animal foods, free-range chicken and eggs.

For many this may mean beginning with a special healing diet of kicharee, based on a combination of rice (white or brown), split yellow mungs beans, spices such as turmeric, cumin coriander and ghee.

Omega-3 fatty acids are well known to reduce inflammation throughout the body and are extremely beneficial for the treatment of RA. Various brands are of good quality including Nordic Naturals, Life Extension, Dr. Mercola’s krill oil, Carlsen’s, and Kirkland’s. I suggest a daily dose of 1000 to 1600 milligrams daily.

Alpha Lipoic Acid (ALA) is a powerful detoxifying antioxidant with special affinity for the liver and kidneys. ALA assists in converting glucose into energy, improves insulin sensitivity which asserts blood sugar control and is even known to reduce neuropathy in diabetics. It also naturally increases glutathione, the most powerful antioxidant that is produced naturally by our body. There are many fine products on the market, including Source Naturals time-released capsules available in 100, 300 and 600 mg doses, NOW Alpha Lipoic Acid, Pure Encapsulations Metabolic Xtra, and Vitacost. Take 200-600 mg daily.

A single daily good quality multivitamin should be taken for a few months to remedy any vitamin deficiencies. I use Source Natural’s Life Force Vitamins, but there are many other good quality multivitamins on the market. I usually like anything that Now brand produces. Rainbow Light also has a fine multivitamin.

Herbal formulas:

The single most effective formula I have used with consistent beneficial results is the TCM formula known as Angelica and Loranthes Combination (Du Huo Ji Sheng Tang). The brand I most commonly rely on is Active Herbs formulation called JointsJoy. It is available in easy to swallow pilules or tablets. This consists of a highly concentrated 5:1 herbal formula of 14 herbs, minimal fillers and binders made in a GMP-certified kitchen and imported in accordance with U.S. FDA guidelines. The recommended dose is 6 tablets taken two or three times daily with warm water. Because an RA patient might be taking this supplement for several months, I recommend purchasing a case of 12bottles at a time.

Another formula that is particularly effective when arthritis flares up in cold, damp weather is Feng Shi Xiao Tong Pian which in Active herbs brand is conveniently called ArthritEZ.

In addition, I recommend two capsules of Planetary Herbals’ Triphala complex which assists in normal detoxification, digestion and elimination. Triphala is a basic formula that can be used for all conditions as well as general health and wellness.

Planetary Herbals’ Flex Ability (Shu Jin San) is a Chinese formula consisting of 10 herbs. It treats arthralgia, both osteo- and rheumatoid arthritis, neuralgia, neuritis, numbness and pain in the legs, hemiplegia, chronic B vitamin deficiency, and paresthesia.  It is famous for increasing flexibility and works more on the muscles and tendons. It is available in liquid extract and tablet form. Take two tablets three times daily.

The above three formulas can be taken concurrently or on alternate weeks. 

Finally, every herbal anti-inflammatory protocol should include turmeric (with other herbs as appropriate for the patient's constitution). I use Planetary’s Full Spectrum Turmeric extract at a dose of 30 to 40 drops three times daily.

Other optional herbs and supplements that can be included are MSM (methylsulfonylmethane) and Planetary’s Guggul-Cholest.

One should get moderate daily exercise; a vigorous walk or swim are excellent options. Yoga stretches, besides making for more flexibility and limberness, also work on activating the deep hormonal systems of the body – be careful to not overdo yoga when beginning as it can result in sprains and strains which may limit further exercise at least for a while. Remember, a personal exercise routine is not a competition. Any exercise can be overdone. All one needs is about a half hour daily.

If one has access and can afford it, a series of acupuncture treatments can be extremely beneficial, especially if the acupuncturist employs methods other than just needles such as moxibustion  (applying heat close to acupoints and areas on the body), gua sha (a relatively painless rubbing over specific areas), and cupping therapies. I feel confident that this protocol will absolutely relieve or cure most cases of early stage arthritic conditions of all kinds (before deformity has occurred) and relieve inflammation and pain generally in all cases.

If one wishes to set up a telephone consultation or an office visit with myself, Lesley or one of my associates call (831) 429-8066, East West Herb and Acupuncture Clinic 912 Center Street, Santa Cruz, California.






[1] Sjogren’s syndrome is characterized by dry eyes and dry mouth. It is also an autoimmune disease. In traditional herbal medicine Sjogren’s syndrome is a form of Yin Deficiency. I have also treated this condition successfully with a dietary and herbal protocol.


Gluten or dairy intolerant? You may not need to give up wheat and dairy, says Dr. John Douillard, DC, in his book Eat Wheat (Morgan James Publishing, 2017). Backed by years of clinical experience helping people who previously were unable to digest wheat and dairy, Dr. Douillard employs traditional thousands-of-years-old Ayurvedic principles backed by more than 600 scientific studies to develop the methods described in his book for gut health.

His conclusion? Most who claim to experience varied and myriad symptoms of discomfort as a result of eating dairy, wheat and other glutinous grains is the result of a toxic condition that has weakened their digestion.

Based on my own clinical experience, I agree that, with the exception of the less than 0.5 to 1% who actually have lactose intolerance and celiac disease (the latter being a serious conditions that can be medically diagnosed through simple clinical tests) should absolutely avoid consuming these foods. However, the rash of symptoms attributed to eating dairy and wheat ranging from simple bloating, heavy dull feeling and lethargy after eating, to a wide range of metabolic to mental and emotional conditions may do better if they view these as symptoms that may benefit from treatment rather than a primary handicap.

Thus I appreciate that this is not just another theoretical book but one that lists numerous cases of his patients who were suffering from various degrees of gluten and dairy sensitivities and intolerances and who, after undergoing recommended detoxification cleanses, reported that not only were they able to eat these foods again, but with better digestion and a more lasting improvement of health and well-being overall.

All systems of natural healing believe that the foundation to health is a healthy gut, meaning the ability to break down and assimilate vital nutrients and efficiently eliminate metabolic wastes. I agree with Douillard’s thesis that the underlying causes of gluten sensitivity-intolerance is a toxic, weak digestive system. In fact the symptoms associated with gluten sensitivity-intolerance are common to all traditional healing systems. The Western herbal tradition addresses this with the use of digestive bitters such as Angostura bitters commonly sold in liquor stores throughout the world and originally designed to relieve digestive problems by stimulating hydrochloric acid and biliary secretions. Then there is Traditional Chinese Medicine (TCM) with dietary and herbal treatment its most common diagnoses: Spleen Qi Deficiency, Liver-Spleen Qi Stagnation and diseases caused by Phlegm. Finally Dr. Douillard’s specialty, Ayurvedic medicine, has a wide range of treatment and herbs for specific digestive problems and the elimination of deep-seated toxins called ‘ama’ which is related to the TCM concept of invisible Phlegm, or the lymphatic system which according to Douillard is lodged in the fat cells.

In fact, Douillard describes how the most  recent research has discovered a direct connection of the lymphatic system between the GI tract and the brain.  This explains the Chinese description of schizophrenia and psychosis as “invisible Phlegm masking the brain” and the relationship between gluten sensitivity-intolerance and the brain in Dr. Perlmutter’s book, Grain Brain. However, merely eliminating gluten not only deprives us of the pleasure derived from these foods but also a wide range of associated vital nutrients they contain, including fiber, iron, zinc, folate, niacin, thiamine, riboflavin, calcium, Vitamin B12, and phosphorus.

With approximately 21% of the population currently adopting a gluten-free diet and a $9 billion gluten-free food industry (in 2014) to support it, there has been little interest in finding a deeper cause or cure. In fact, Douillard exemplifies how the condition he calls "toxicity impaired digestion" (TID) is best treated with traditional medicine, diet and herbs. 

His approach is to eliminate all processed and refined food from the diet, engage in periodic cleanses which he describes and are freely available on his website www.Lifespa.com, and adopt a seasonal approach to foods based on regional availability which is described in his book and his previous book, The Four Seasons Diet, also based on traditional Ayurvedic dietetics.

On a recent vacation in Kauai, my wife, Lesley and I underwent Douillard’s four-day cleanse based on taking increasing spoonfuls of ghee first thing each morning and eat no other fat throughout the rest of the day; and the traditional Ayurvedic healing food kichari, consisting of split yellow mung beans and white rice, with traditional healing spices of turmeric, coriander and cumin prepared without ghee, three times each day. In addition warm water is sipped every 10 or 15 minutes and certain Ayurvedic herbs such as triphala for eliminating metabolic waste were taken.

The fast was remarkably easy to follow and adhere to and there was little hunger for other foods. You can download the details of Dr. Douillard’s short cleanse or even embark on his 28-day cleanse. There are three levels of foods to use besides the basic kichari and ghee, which is the foundation. One is to add vegetables and fruit to the regime and another, especially for those with low blood sugar, to add white meat such as chicken.

The most unusual and a key component of the diet was the morning intake of ghee – pure butter fat. Ghee is considered one of the most healing foods in Ayurvedic and Tibetan medicine. Like all fat, it satisfies hunger but uniquely it cleanses and heals the walls of the intestines, stimulates the production of new bile for the liver and gall bladder, strongly strengthens the immune system, and encourages eliimination of old “ama” -- difficult to discharge, toxin-laden fat from the body – literally consuming good fat to eliminate bad.

We both felt significant benefit from this short cleanse and it did seem to ‘reset’ our digestive systems. We look forward to repeating the cleanse.

For many, reintroducing grains and dairy back into the diet may have to be a gradual process, beginning with yogurt, cheese or ‘scalded’ organic whole milk; with glutinous grains such as wheat, and occasional small servings of whole grains.

Douillard's point, in short, is that sensitivity-intolerance to these foods is not the cause but a symptom of deeper digestive imbalance, which if left untreated can be a precursor to more serious diseases later in life.  

Dr. John Douillard is the author of six books, numerous articles on natural health and fitness and the creator of Lifespa.com a respected source for Ayurvedic health and wellness.


There is one kitchen spice most of us could use more of in our lives: cardamom.

While there are different types of cardamom (see end for details), just the plain old spice you have in your kitchen cabinet will do. It is a powerful digestive aid that comes in quite handy, for maintenance or acute distress. But it’s best as a preventative, too.

Cardamom is a very ancient spice. It is the seed of the perennial tropical vine in the ginger (Zingiberaceae) family. In Traditional Chinese Medicine (TCM), it is in the category of herbs called, “aromatic dispel dampness.” This means its aroma plus drying nature help to eliminate dampness in the digestive tract.

Symptoms of dampness include anywhere from a feeling of heaviness or edema to loose stools, diarrhea, poor appetite, nausea, vomiting, acid reflux, abdominal distention, chest fullness or an oppressive sensation in the chest, and lethargy.

Further, when dampness congeals over time it forms phlegm, which in turn creates tumors, cysts, soft lumps, nodules, cancer, numbness, tremors and paralysis.

As well, cardamom alleviates food stagnation, or food that is poorly digested and so congests and collects in the body. This condition may be either acute or chronic. The acute type is similar to the after-effects of over-eating at a holiday meal and can even cause pain in the heart region; the chronic type occurs when digestion becomes impaired and the body can no longer fully digest or absorb nutrients.

When food overwhelms the stomach, it results in such symptoms as sour regurgitation, reflux or vomiting, belching and/or hiccupping, and foul breath, or it passes on to the intestines causing foul gas, loose stool, or foul-smelling diarrhea. The partially digested food then lingers in the body, congesting the organs and channels and slowing the circulation of Qi, Blood and fluids.

Acute food stagnation in the upper part of the body can cause palpitations or stuffiness around the heart and in the epigastric region. Many folks go to emergency care thinking they are having a heart attack, but what they are really experiencing is acute food congestion in the stomach.

In the middle part of the body, acute food stagnation can cause lack of appetite, fullness and distention of the epigastrium relieved by vomiting; insomnia with a full feeling in the stomach region, unrelieved hiccupping, epigastric spasms, nausea, foul breath, sour regurgitation, belching, abdominal fullness, bloating, and poor distribution and/or assimilation of nutrients.

Still wonder if you have dampness? Stick out your tongue in front of a mirror. If it’s swollen and/or has teeth indentations on the sides (called scallops), then you have dampness. If you have a white or yellow coat, that’s also dampness. The thicker and greasier the coat, the more the dampness has turned to food stagnation or phlegm.

So, are you inspired to find a solution?

Use cardamom!

This is the reason I’ve outlined so many symptoms here: cardamom can treat them all and this is one spice to have on hand. It will save you many a discomforting hour and perhaps even a trip to some sort of emergency care.

And yet, cardamom is a great herb to include on a daily basis. Most people include a long list of dampening foods in their diets: iced drinks, cold foods directly from the refrigerator, smoothies, dairy, soy, soy milk, rice milk, oatmeal, cucumbers, flour products (muffins, bagels, bread, pasta, chips, crackers, pastries), excess raw foods, salads, yogurt, ice cream, potatoes, fruit juices, excess fruit in general, specifically bananas, citrus and persimmons – I could go on and on.

TCM uses true cardamom, or sha ren (Amomum villosum, A. xanthiodes, Elettaria villosa, Cardamomum villosum)) for the above symptoms as well as morning sickness and a restless fetus. It is also frequently added to formulas with cloying herbs to aid in their digestion.

Ayurveda also widely uses cardamom. It is given to eliminate mucus and for colds, coughs, bronchitis, hoarseness, asthma, and a loss of the ability to taste.

For those who want all the specifics, here they are:


Cardamom Fruit, Round (Amomum cardamomum, Elettaria cardamomum)

Bai dou kou (Chinese)                                                      Family: Zingiberaceae

Also named: cardamom cluster, Amomi Fructus rotundus

Energy and flavors: warm, acrid

Organs and channels affected: Spleen, Stomach, Lung

Chemical constituents: d-camphor, d-borneol

Properties and actions: carminative, stomachic, antiemetic, expectorant; aromatically transforms Dampness, directs Qi downward

Contraindications: Deficient Blood or Yin

Dosage: 3-6g in decoction (added in the last five minutes); 2-5g as a powder; 20-60 drops tincture (1:10 @40%ABV), TID

Cardamom Seed, True  (Amomum villosum, A. xanthiodes, Elettaria villosa, Cardamomum villosum)

Sha ren (Chinese)                                                              Family: Zingiberaceae

Also named: grains-of-paradise fruit, Amomi Fructus

Energy and flavors: warm, acrid

Organs and channels affected: Spleen, Stomach, Lungs

Chemical constituents: 2-8% volatile oil comprising limonene, terpinene, dipentene, camphor, borneol

Properties and actions: antiemetic, carminative, antidiarrheal, aromatic, stimulant, stomachic, antiemetic; aromatically transforms Dampness, regulates Qi

Contraindications: Deficient Yin with Heat signs.

Dosage: 3-6g; Because of its essential oil content, Cardamom is added in the last five minutes of a decoction; 2-5g as a powder; 30-90 drops tincture (1:10 @40%ABV), TID


In my previous blog on treating H. pylori-induced stomach inflammation with herbs, I touch briefly on a fundamental difference between conventional and complementary medicine: namely, that conventional medicine prefers to identify an isolated pathogen or discrete named diagnosis which it aims to treat singularly; whereas complementary or traditional medicine relies on signs and symptoms, within the unique individual and their personal conformation, and how these elements fit into a time-tested model of healing.

Being an herbalist means learning to think like a herbalist, which apart from a special knowledge of the therapeutic properties of plants also means to not overly focus on the symptoms of a disease but also the particular unique physiological ‘terrain’ from which the disease and its symptoms arise. With Chinese medicine, this means treating ‘root (cause) and branch (symptom) based on principles of yin and yang. In Ayurveda, it means differentiating the individual’s underlying prakriti (doshic or humoral imbalance) from the vikruti (doshic disease imbalance).

There are several layers of healing. One is to disguise the symptom, another is to deal with the microbiological cause of the symptoms. Still another is to treat the “cause of the cause” which is the imbalances in the body that predispose one to develop such things as infections (like H. pylori overgrowth). Still another cause beyond these physical ones are the psycho-spiritual reasons one develops a disease.

Relief or “cure” can be achieved at any of these levels. The first treatment principle should be to relieve the symptoms, which is the most superficial level of healing; second, treat the “cause of the cause” being the most physiologically beneficial level overall: and then attention must be paid to the third, psycho-spiritual level, which is the most profound.

Only masking the symptoms, which is the usual approach in Western medicine such as when antibiotics and anti-inflammatory drugs such as cortisone are given, is fraught with possibly damaging side effects. This is why many people seek the herbalist or acupuncturist for the second and third levels of healing. Every healer has some facility to work on each of these levels but the herbalist and acupuncturist uniquely specialize on second “cause-of-cause” level.

The third, psycho-spiritual level may either be all encompassing or may provide other levels of relief beyond the physical.

Addressing all three of these levels, with respect to the individual patient’s particular physiology, history of illness and mental or emotional disposition, is the definition of “wholistic” healing to which most herbalists and traditional practitioners aspire. It is an approach which, in my opinion, is most likely to bring about the sort of transformation that leads to deep and lasting healing.

Recently, a colleague sent me the following question:

A friend in Canada tested positive for H. pylori bacteria. Of course, the Western doctor he goes to wanted to start heavy antibiotic treatment. Plus, he said he would need to be on some 'pill' for the rest of his life! He is refusing until he can seek out alternative answers to this. He is 70 yrs. old, does not have a hiatal hernia, just a bit of indigestion at times.

What is Helicobacter pylori?

Helicobacter pylori is a common bacterium that many have with or without any noticeable symptoms. Recently a study found that Otzi, the 5,300-year-old ice-mummy, was also infected with H. pylori. Today it is estimated that it is present in about half the population.

H. pylori is known to produce an enzyme, urease, that allows the bacteria to live in harsh acidic environments such as the stomach. Urease reacts with urea to form ammonia which can neutralize enough of the stomach acid to allow organisms to survive in tissues for years. It is highly contagious and is transmitted through saliva, fecal contamination in food or water, and poor hygienic practices in general. As stated, the good news is that most people do not exhibit any symptoms. However, if enough of the stomach acid is neutralized, it can be a factor behind many acute gastrointestinal problems such as gastritis and GI tract ulcers.

The Herbal Approach to GI Inflammation

I’ve been involved with the study and practice of herbal medicine since 1968. In all of that time, I focused on treating the patient more than the disease. This is because my model, traditional herbalism, does not focus on treating specific pathogens associated with a disease, but the whole disease complex itself.

In other words, a Western herbalist may treat gastrointestinal symptoms caused by H. pylori with herbs not specifically targeted to eradicating the bacterium, but with herbs that reliably treat ulcers, abdominal and acid reflux. An Ayurvedic herbalist might treat these conditions as a humoral imbalance of excess pitta. A traditional Chinese herbalist would treat it based on Eight Principles and pattern analysis. In all three models, there is no particular advantage in testing and discovering that the inflammation is caused by H. pylori.

Today, many complementary health practitioners seeking to impress their patients too often resort to describing their diseases based on a Western medical model. The problem is that herbs are more food-like than drugs, exerting a broader function on restoring homeostasis and health. Still, many herbs do have specific tropisms or indications. For the patient described above, look to herbs that treat symptoms of ulcers, acid reflux, belching, bloating, nausea, vomiting, and abdominal pain as symptoms of gastritis. All of these conditions are effectively treated with dietary and herbal treatment.

So while I’ve not treated H. pylori as a discrete entity, I have had a lot of experience successfully treating all the conditions previously mentioned. Because people have responded positively, I can only assume that the diet and herbs I prescribe regularly such as Triphala inhibit the growth of H. pylori.

Herbs for Gastritis, Acid Reflux, and GI Tract Ulcers

Bitters, triphala, goldenseal, and coptis are among the many botanical remedies taken singly or in a formula for treating gastritis, acid reflux, and gi tract ulcers. These herbs treat a broad range of gastric imbalances but have also substantiated research that they are effective for H. pylori. 

Berberine is a constituent of herbs such as goldenseal, coptis, barberry, Oregon grape and the Ayurvedic herb guduchi (Tinospora cordifolia).  All of these have been shown to have broad-spectrum antibiotic and antipathogenic properties. Studies in vitro have demonstrated that berberine can inhibit H pylori. While these may not be robust enough to eradicate the organism entirely (if that is even possible), when used in a compound herbal formulation for gastritis, or in bitters, along with probiotic foods and a balanced diet, they will certainly contribute to a multilayered comprehensive gut healing regime.

Triphala, an ancient Ayurvedic healing compound consisting of three fruits, Terminalia belerica, T. emblica, commonly known as “amla” and T. Chebula or black myrobalan (Chinese: he zi), also has broad spectrum antipathogenic properties.  Chebula or black myrobalan has been cited as effective against all harmful bacteria and specifically effective for inhibiting urease active of H. pylori.

The remaining two fruits in Triphala are also effective against H. pylori, especially amla (T. emblica). Amla fruit is one of the greatest antioxidants in the plant kingdom and is highly regarded both for its nutritional and for its medicinal benefits. It is claimed as one of the two or three highest known sources of natural tannins and Vitamin C which is impervious to both age and heating. Research confirms what native people of India have known for millennia, that Amla is good for the health of the whole body, especially the liver and GI tract. It is an effective treatment for gastritis, Crohn's, iBS, stomach and duodenal ulcers and to inhibit the growth of H. pylori in the stomach.

Tinospora cordifolia, called “guduchi” and “the body’s protector” is bitter, pungent and astringent with a post-digestive ‘sweet’ effect meaning that it is an antipathogenic herb with tonic-nutritive properties. It is one of the most powerful antipathogenic herbs of special benefit for inflammatory gastric disorders.

Deglycyrrhizinated licorice root (DGL) is a well-established anti-ulceration and mucosal healing agent. DGL can coat and soothe the intestinal lining and promote the healing of inflamed tissue and ulcers. Research suggests that flavonoids in licorice have impressive antimicrobial activity against H. pylori. The flavonoids have been shown to have antimicrobial activity against strains of H. pylori that were resistant to clarithromycin and amoxicillin, two of the primary antibiotics used in triple therapy. Some forms of licorice can elevate blood pressure but because DGL has low glycyrrhizin levels it is safe to take if you have high blood pressure.

Sulforaphane is a naturally occurring chemical found in cruciferous vegetables such as broccoli, cabbage and brussels sprouts. Some studies have demonstrated that it can inhibit H. pylori. Eating cruciferous vegetables, especially broccoli sprouts, will ensure that you get plenty of sulforaphane, but it is also available in capsule form from several supplement manufacturers, including a product called Broccomax.

Some studies have suggested that Vitamin C may inhibit and even kill H. pylori but more research is needed to determine the optimal dosing and program duration. Even if Vitamin C does not eradicate H. pylori, it is still worth taking a controlled dose because studies clearly show that Vitamin C levels in the stomach lining can be reduced when H. pylori is present, largely as a result of the inflammatory and oxidative stress caused by the infection. Vitamin C is also an excellent nutrient for assisting with gut healing.

Vitamin U – also known as MSM – is found in raw cabbage. In fact, Vitamin U is not a vitamin at all. Cabbage juice has been studied extensively in Russia and other Eastern European countries for the healing of damaged and eroded intestinal mucosa. It appears to enhance the healing of damaged tissue and may assist in healing ulcers.

When I consider what the most useful single herb I know with these same antiviral, antibacterial, antifungal – in fact, every ‘anti’ property we would need to fight off harmful  pathogens—is, it is Isatis tinctoria, an herb commonly known in old English as “woad,” meaning “weed.” As an ancient East - West cruciferous family medicinal herb, it happens to have all of the same antipathogenic sulfur compounds found in cruciferous vegetables and of course biologic MSM sulfur. Both the leaf and the root of Isatis are used in Traditional Chinese Medicine called da qing ye and ban lan gen respectively. These are classified as bitter and cold, which from an herbalist’s perspective means they are broadly antipathogenic and reserved for short-term use to treat the most stubborn pathogens such as viruses but are equally effective for bacteria and funguses as well.

Acupressure applied to Gall Bladder 20.

According to the World Health Organization (WHO) there are 361 charted acupuncture points on the body. Acupuncturists generally recognize any active point on the body that is particularly sensitive as an acupuncture point, so understood in this way, the number of actual points are limitless.

Within the medical tradition of Indian Ayurvedic medicine, there is a comparable number of points on the body that can be treated called marmas. Like Chinese acupuncture the science of marmani developed in India about 5,000 years ago in Vedic times. Ayurvedic texts describe 117 major marma points. Located at anatomical sites where veins, arteries, tendons, bones or joints intersect, they are similar to the more numerous Chinese acupoints as today they are also stimulated by palpation for both diagnosis and healing. Interestingly, about 75 of the 117 principal marma points exactly correspond to principle acupoints used in Chinese medicine.

Many of the points on the Chinese Gall Bladder meridian, especially on the head and shoulders, treat the condition known in Traditional Chinese Medicine as “Wind.” There are broadly two types of wind: “External Wind,” which includes inflammations on the surface layers of the body including allergic reactions affecting the skin, eyes, ears and nasal sinuses as well as viral and bacterial conditions such as colds, flu, headaches and other common afflictions. “Internal Wind” is completely different and includes more chronic diseases such as epilepsy and Parkinson’s. In both cases, the description “Wind” denotes diseases that represent some fundamental instability.

While not exactly corresponding in location, the Chinese acupoint called feng chi or “Wind Palace,” also less poetically known as Gall Bladder 20 (GB 20), seems closely related in action to the Ayurvedic point Krikatika Marma. These points are located within an inch of each other at the occipital base of the skull can be stimulated to treat allergies, itchy eyes and all kinds of headaches. With effective 4- to 5-second stimulation, one can experience a feeling of immediate clearing in the head which caused one of my acupoint students to dub the point/s a “brain cooler.”

Locating GB20 and Krikatika Marma

Feng Chi (GB20) is in a natural groove located behind the ear at the base of the posterior mastoid (ear) bone where the muscles of the neck attach to the skull. Krikatika marma is on both sides of the central axis leading into the skull at the juncture of the 2nd cervical vertebra.

Fortunately both these points are easy to find and easy to massage even on oneself. To locate GB 20, simply interlock the fingers of both hands palms facing inward and cradle the occiput on the back of the skull. Both your thumbs should naturally fall to the grove connecting the neck and the skull on your neck.  Krikatika marma is one inch towards the center on either side of the cervical spine.

These both connect to the brain and are very powerful. Until you become more familiar with their effect you should stimulate them deeply but probably not more than 4 to 5 seconds each.

  • Both points benefit the head, neck, eyes and ears
  • Relieve local pains such as headaches
  • Relieves tension and both physical and emotional stress
  • Treats respiratory conditions such as colds, flu and asthma

They can be used to immediately relieve allergy symptoms especially of the eyes, ears and nasal passages. Neck pain and stiffness with a decrease in range of motion, stress-related emotional disturbance, middle ear infections, tinnitus, Meniere’s syndrome, and asthma.

I sometimes think of GB 20 as a “lobelia” point because like the herb Lobelia inflata, it has such powerful antispasmodic (Wind-relieving) properties. Similarly, stimulating Krikatika affects the upper lobes of the lung, stimulating bronchodilation and the relief of asthma.

GB 20 and Krikatika marma offer instant relief of Meniere's disease which is a disorder of the inner ear that causes episodes of spinning vertigo, feeling of fullness in the ear and fluctuating hearing loss which is progressive, ultimately leading to permanent loss of hearing and ringing in the ear (tinnitus).

Meniere's disease affects only one ear and can occur at any age but usually starts between the ages of 20 and 50. It's considered a chronic condition, but various treatments can help relieve symptoms and minimize the long-term impact on your life. There is no known cure for Meniere’s disease and there are a variety of Western drugs usually with varying degrees of undesirable side effects, ranging from anti-nausea drugs and valium to steroids and even surgical intervention to cut off neurological response. Certainly for this disease alone, GB 20 and krikatika marma, with no side effects, are worth trying.

GB 20 and Krikatika marma are also useful for those who may experience brain fog and eyestrain from study or working with a computer for long hours. It seems quite natural that one might raise their finger-clasped hands above and behind their head occasionally not only to stretch and take in more oxygen but also to drop down as they take a deep inhale and maintaining a brief inhaled breath allow their thumbs to stimulate these two acupoints points for the price of one. One can easily extend the benefit of these points by massaging back and forth between these two points.

Note: this can be a very powerful experiential treatment.  Start out cautiously massaging no more the 4 or 5 seconds on each side and wait an hour or so before repeating.

Itchy, Severely Inflamed Eye

One of the common problems associated with aging is dry eyes. This can be complicated with an increased allergic sensitivity to airborne allergens. One randomized, placebo-controlled study showed that stimulation of GB 20 in dry-eye patients was significantly improved after 4-weeks of treatment.

I recently had a patient with a severe eye inflammation exhibiting symptoms of severe itchiness, redness, and swelling which caused him to go to his ophthalmologist for a remedy.

The ophthalmologist diagnosed it as inflammation caused by allergy and prescribed some exorbitantly expensive cortisone-based eye drops for relief. It was at this point that my patient sought alternative treatment. Because he would be traveling and it would not be convenient to make an herbal eyewash, I showed him how to massage GB 20.

This point worked like a charm, making it unfortunate that he had already spent nearly $200 for a tiny container of no more than a tablespoon of cortisone eyedrops which he never used. (Believe it or not, it was a cheaper brand from the original prescription which with even Medicare would have cost over $600!)

The first treatment priority was to allay the itching. Each time he felt an urge to rub his eyes he would massage GB 20 for 4 to 5 seconds as described. The itching completely stopped, lasting at first for an hour and after a few times, each time longer until the itching was completely gone.


  1. Shin MS, Kim JI, Lee MS, et al. Acupuncture for treating dry eye: a randomized placebo-controlled trial. Acta Ophthalmol. 2010 Dec;88(8):e328-33. doi: 10.1111/j.1755-3768.2010.02027.x. Epub 2010 Nov 10
  2. MS, Kim JI, Lee MS, et al. Acupuncture for treating dry eye: a randomized placebo-controlled trial. Acta Ophthalmol. 2010 Dec;88(8):e328-33. doi: 10.1111/j.1755-3768.2010.02027.x. Epub 2010 Nov 10.
  3. Takayama S, Seki T, Nakazawa T, et al. N. Short-term effects of acupuncture on open-angle glaucoma in retrobulbar circulation: additional therapy to standard medication. Evid Based Complement Alternat Med. 2011;2011:157090. Epub 2011 Mar 7. PubMed PMID: 21437193
The three fruits of Triphala.

My clinical experience using the Ayurvedic formula Triphala is extensive, based on literally thousands of cases over the course or 25 years. It is only within the last three years that I can proclaim it to be as near a specific for IBS, ulcerative colitis and Crohn’s disease as one can find.

I discovered this use for it quite by accident working with a patient with the worst case of ulcerative colitis I have ever encountered. Because this was a condition of extreme diarrhea, I initially never thought to prescribe Triphala because of its known laxative properties; Triphala is also a specific treatment for laxative-dependent constipation, so it seems counterintuitive to employ it in the treatment of ulcerative colitis, which is basically an intractable type of diarrhea. Even though I had read that Triphala was good for both constipation and diarrhea, I didn’t want to exacerbate an already bad inflammatory condition.

To step back for a moment, I’ve written about Triphala extensively before, but to briefly recap, I use Triphala as a foundation formula appropriate for all diseases. It is detoxifying, astringent, and laxative. Literally millions of people in India and now throughout the world use it, and there have been no serious adverse effects to its regular use, whether daily, or weekly. Triphala perfectly balances the chemistry of the entire GI tract so that healthy flora will flourish. Triphala helps us to eliminate all that we don’t need while retaining what we do.

A patient came to me who had suffered for years with the worse case of ulcerative colitis I’ve ever encountered clinically. I shared his full story on a blog here. I was only able to occasionally relieve his symptoms with Chinese herbs, health supplements and a severely restricted diet avoid all sugar, refined foods, dairy and grains.  Even with periods of surcease, his condition would recur and we’d have to come up with a completely different game plan to help him recover.

But after just three days on two “00” sized capsules every waking hour during the day, he was symptom-free!

It seemed that indeed, the ancient recommendations for Triphala being good for both constipation and diarrhea were correct. 

I shared this story with a number of colleagues and students and they all reported the same results. They were curing the incurables, IBS and Crohn’s disease. The only difference was that they were able to achieve these positive results with a far more modest disease level and regime. They simply gave 3 “00” capsules three times daily and they got the same results as I did giving 2 capsules hourly.

Most recently, I gave it to a woman who had medically diagnosed Crohn’s disease as well as rheumatoid arthritis for which I prescribed other herbs. In this case I only prescribed 3 “00” sized capsules of Triphala three times daily. This was enough to completely stop her Crohn’s disease symptoms within three days.

Her rheumatoid arthritis symptoms were resolved by her embarking on a 10-day kitchari fast and the Chinese formula Du Huo Ji Sheng Tang (Du huo angelica and loranthes combination) in pill form. However it was the Triphala that completely stopped all symptoms of Crohn’s disease which had plagued her for years previous.  While I am reluctant to use the word “cure,” she continues symptom-free for more than six months and continues to take Triphala now at the modest dose of only 2 “00” sized capsules 2 or 3 times daily, she claims that she is cured of her Crohn’s disease. 

With the exception of the occasional day or even week off of all supplements which is a good idea generally, she has not stopped taking Triphala. Why should she? In India, Triphala is considered safe for all young and old and is even given to infants. It is a regular household item. As the saying there goes, “No mother? No worry, so long as you have Triphala.”

IBS, Crohn’s and ulcerative colitis are such terrible diseases affecting 10 to 15% of the population in the US, which is anywhere from 25 to 45 million people. If only all these sufferers and their gastroenterologists knew about this single safe and most effective formula, consider how many might benefit.

I have no way of knowing whether it will work for everyone, but I do know it is safe based on my own and my colleagues’ and my many students’ experience. A bottle of Triphala powder or capsules doesn’t cost much; if there is a chance it can heal these inflammatory bowel conditions, it is worth a try with little sacrifice.

Elderberry Juice for IBS?

Besides Triphala for IBS, I recently came across a single case of an individual who suffered from severe symptoms of inflammatory bowel disease and cured himself with elderberry juice. This is a heretofore unknown use of the famous elderberry previously only considered as a treatment for colds and flu. What I found interesting about this was that like Triphala, elderberry is a fruit that contains both laxative and astringent properties. Perhaps this once sacred herb of the ancient Celts is a northern European counterpart as an effective herb for IBS. Let us know about your experiences with Triphala and/or elderberries for IBS.





CLOVE (Eugenia caryophyllata, E. aromaticum, Syzygium aromaticum)

Family: Myrtaceae

Also called: caryophylli or ding xian (Chinese)

Parts used: flower bud

Energy and flavors: warm, acrid, aromoatic

Organs and channels affected: Stomach, Spleen, Kidney

Chemical constituents: essential oils, especially eugenol, tannins, phenolic acids, methyl salicylate (painkiller), the flavonoids eugenin, kaempferol, rhamnetin, and eugenitin, triterpenoids such as oleanolic acid, stigmasterol, and campesterol, and several sesquiterpenes

Properties: stimulant, carminative, antiemetic, anthelmintic, antiseptic, antispasmodic, analgesic

Dosage: 1-3g

Contraindications for clove: Do not use if there’s Internal heat; caution with Deficient Yin, hypertension, or pregnancy; do not give the essential oil internally to children or pregnancy women as eugenol is toxic in relatively small quantities.


When many people think of cloves, they might remember it in sachets to scent closets or drawers, or stuck in hams and baked to imbue flavor. Today, clove is mainly used as a spice, especially for holiday meals. Still, it has many valuable uses outside the spice cabinet, some of which may even be the perfect remedy for you.

Clove is an evergreen tree that grows to about 30 feet and is native to Indonesia and the Malacca Islands (the Spice Islands). It is commercially harvested primarily in Indonesia, India, Madagascar, Zanzibar, Pakistan, Sri Lanka, and Tanzania. Very important in the spice trade, it was – and sill is – used in perfumes, mulled wines and liqueurs, dental products, and insect repellents.

Not too long ago, oranges were littered with cloves to create the Victorian English pomander, used for not only for its scent but to indicate “warmth of feeling.” And many may remember clove cigarettes where cloves were blended with tobacco (the Indonesian kretek) and smoked throughout Asia, Europe, and the United States until 2009 when they were banned in the U.S. (and sold as “cigars” ever since).

Despite all of this historical use as a spice, clove has also been widely used in Chinese and Ayurvedic traditional medicine.

In Chinese medicine, clove is classified as an internal warming herb, helping to dispel Cold and warm the body. It is especially used as a digestive aid and for sexual problems. Because it “brings the Qi down,” it alleviates uprising energy with symptoms of hiccough, vomiting, reflux or nausea. As well, it treats cholera, diarrhea, abdominal pain, poor appetite, stomachache, hernia pain in the uterus, chronic indigestion, and fullness in the stomach and intestines. It is also given for morning sickness (often with ginseng and pogosteme, or patchouli) and for vomiting and diarrhea due to Cold in the Spleen and Stomach.

The Chinese also use cloves for painful abdominal masses, impotence and clear vaginal discharge due to Coldness (Deficient Kidney Yang). One may actually feel coldness in the “womb” (uterus) or vagina and weakness in the legs when clove is indicated.

Ayurvedic medicine uses the dried flower buds as an energizer, carminative, expectorant, analgesic, and aphrodisiac to treat colds, cough, asthma, indigestion, vomiting, toothache, laryngitis, pharyngitis, low blood pressure and impotence. As well, it promotes the flow of fluids in the lymphatic system. For bronchitis and asthma, it is used as an inhalant. Further, clove in animal studies has been shown to lower triglycerides and blood sugar.

Western herbalists use clove as a carminative to increase hydrochloric acid in the stomach and to improve peristalsis. It is also a natural anthelmintic and is applied externally to treat scabies and fungal infections. It is taken for inflammatory and spastic conditions of the gastrointestinal and respiratory tracts, cramps, gas, diarrhea, ulcers, nausea, bronchitis, hoarseness, colds, flu, vomiting,  hypotension, hiccups, colic, and parasites.

Eugeneol, the compound oil in clove, is responsible for most of its aroma. Used in its essential oil form, clove oil may either inhaled for asthma and cough or else a couple of drops topically rubbed over the stomach or abdomen to alleviate pain and indigestion. It also helps muscle fibers contract, making it useful to relieve muscle pain, arthritis, rheumatism and muscle numbness. As a mouthwash, gargle (or else the clove itself chewed), it treats toothache, laryngitis, pharyngitis and halitosis. It is used in dentistry as a topical anesthesia and antiseptic.

And if that’s not enough, clove may be used as an ant repellent!


Despite all these great applications for cloves, I discovered another fabulous use the last several years – as a powerful remedy tor acid regurgitation (GERD). I’ve treated many cases of acid reflux and while most responded well, there were some cases that I found to be particularly stubborn. Yet, even these responded to the use of clove in the Ayurvedic formula, Avipatikar. This formula is hands down the best remedy I found for the treatment of GERD.

Avipatikar churna is a traditional Ayurvedic formula used to  treat digestion. This blend both balances the digestive fire and detoxifies. It soothes the stomach tissues and promotes normal, comfortable levels of acidity during digestion. It also helps direct energy downwards helping to promote post-meal esophageal comfort and healthy elimination.

Avipatikar contains the following herbs:


amla (Emblica officinalis)

  • behada (Terminalia belerica)
  • haritaki (Terminalia chebula)


  • black pepper (Piper nigrum)
  • ginger (Zingiber officinale)
  • long pepper (Piper longum)

green cardamom (Elettaria cardamomum

clove (Syzygium aromatica)

Indian bay leaf (Cinnamomum tamala) – patra

nut grass (Cyperus rotundus) – musta

turpeth (Operculina turpethum) – trivrit


Avipatikar helps many other conditions than heartburn, acid reflux, or GERD; it also treats constipation, diarrhea, gastritis, indigestion and ulcers.

In fact, one study published in the Journal of Clinical and Diagnostic Research in 2013 suggests that Avipatikar shows promise in the treatment of peptic ulcers (a condition marked by sores in the lining of the stomach or the first part of the small intestine). In tests on rats, the study's authors determined that Avipatikar helped thwart the development of peptic ulcers by reducing secretion of gastric acid. According to the study's authors, Avipatikar's ulcer-fighting effects may be similar to those of ranitidine (a medication commonly used in the treatment of ulcers).

Of course you’ve got all the benefits of Triphala added into the formula and that’s an entire blog on its own! (See Michael’s blog on Triphala for more details.)

One Ayurvedic doctor told me that clove was the main ingredient in Avipatikar, which got me thinking about using just clove power and sugar together as a simple acute remedy if one didn’t have the formula on hand. Make it by mixing honey or barley malt with clove powder and eating in small 1/8 – ¼  tsp. doses with meals.

Note that the honey, or sugar, is an important part of this remedy. This makes sense to me because in Chinese medicine small amounts of sugar (mainly barley malt or maltose) tonifies the Spleen and Stomach, helping digestion and increasing energy. The same goes here with its addition to clove as a simple remedy.

Another great way to take Avipatikar is the Planetary Formula, Avi-Pro, which is Avipatikar in tablet form! Take the indicated dose on the bottle with a teaspoon of honey or barley malt to enhance its effectiveness.

Cook with Clove

As you prepare your meals, remember to include clove in some form or another. Pinches added to pumpkin or apple pies or given after meals as a digestive electuary (mixed with a little honey and taken in 1/8 – ¼ tsp. doses), will definitely help alleviate the indigestion, reflux, gas, bloating, burping, and fullness so often experienced after big meals.

As we continue this blog series on Yin Deficiency (with Heat), I want to make clear that the description of Heat hereby discussed is confined to the organic pattern of Heat and not the description of the external contraction of Heat in terms of communicable bacterial and viral diseases. This was developed by Ye Tian Xi (17th century) with the Four Levels of warm disease. There is a similarity between the two types of Heat but the greatest difference is that warm disease (Wen Bing) occurs as a result of an externally contracted pathogen while the category of Heat described here is one that develops from diet, stress and lifestyle. 

Linear or goal-oriented thought processes are usually the basis of Western thought and medical science, but Traditional Chinese Medicine is much more complex. It is based on a circular understanding of the universe where everything returns to its source before manifesting once again.

Yin and Yang, a nutshell description of what Western physiology calls “homeostasis,” is the basis for all manifestation. Yin Deficiency is a progression were an excess leads to deficiency and deficiency leads to excess.

Yin Deficiency in the body can occur for years before giving rise to Empty Heat. In my experience, many of the strange symptoms people sometimes have that can’t be explained by any known pathology, such as a strange itch or rash on one part of the body, a sensitivity to smell, foods, allergies, are possible signs of Yin Deficiency. Some of these symptoms may be Empty Heat signs and not receptive to the same kind of Heat-clearing and/or anti-inflammatories as Full or Excess Heat.

In fact, they are impossible to fully resolve without addressing the underlying Yin Deficiency, which must be treated with Yin-nourishing and Deficient Heat-clearing herbs.

Before one can treat Yin Deficiency with herbs, it is first necessary to identify which herbs ‘nourish Yin.’ Unfortunately thinking in terms of Western herbalism where such concepts are foreign makes it more difficult to identify an herb that can be used as a Yin Tonic. However, considering that Yin tonics are lubricating and cooling (anti-inflammatory), oils such as fish liver oils, olive oil, borage seed or evening primrose oil could be considered a Yin tonic in a treatment protocol. Or one might prescribe aloe vera gel. Perhaps herbs such as comfrey, slippery elm and marshmallow root would have some cooling demulcent Yin tonic properties. These would be combined with certain mild Heat-clearing herbs including dandelion and/or burdock root – that is, herbs that clear Heat but add substance.

Concomitantly we also need to know which herbs deplete Yin. Obviously if the body is over-amped and in burnout mode, coffee, cayenne pepper and other stimulants would be contraindicated. Herbs that actively promote detoxification and elimination such as all the laxative herbs and strong liver-detoxifying cholagogues would also be contraindicated. However, milk thistle seed containing 70% silymarin has some nutritive and nourishing properties so that it could definitely be indicated for Yin Deficiency.

In Ayurveda we look to herbs such as aloe vera and shatavari (wild asparagus root), Amla fruit, possibly shilajit (although warm) as Yin tonics combined with Heat-clearing detoxifying herbs such as guduchi (Tinospora cordifolia).

The major Chinese formula for Yin Deficiency is Zhi Bai di Huang (Anemarrhena and Phellodendron Combination, see formula below), which is available in pill or other forms. To nourish the weakened organ and clear Deficient Heat requires herbs such as Moutan peony (mu dan pi), anemarrhena (zhi mu), phellodendron tree bark (huang bai), and others that may be used.

In the body, there is a pattern of Yin Deficiency without Empty Heat, and one with Empty Heat for every organ which in Traditional Chinese Medicine means the Heart, Spleen, Stomach, Lungs, Kidneys and Liver. Herbs for treating Yin Deficiency are sweet, cool and moist while those that clear Empty Heat, which in excess would be called Yin Fire, are bitter and cold such as coptis and goldenseal. As previously described many times Yin Tonic and Deficiency Heat-clearing herbs are combined.

This is not the time and space to go more thoroughly describing all the different manifestations of Heat in Traditional Chinese Medicine but following is a list from Maciocia’s book “Clinical Pearls”:

  • Excess or Full Heat
  • Heat from Qi stagnation
  • Empty or Deficient Heat
  • A distinction between Heat and Fire
  • Damp-Heat
  • Phlegm-Heat
  • Latent Heat
  • Yin Fire

The inspiration for this article was derived from Maciocia’s book and for those who want a more in depth discussion based on TCM principles I highly recommend the article in his book. He also offers a number of wonderful formulas corresponding to each of the above imbalances.

The Causes of Heat

Excess or Full Heat is the same as “Wind Heat,” as opposed to Deficient or Empty Heat.

Yin Deficiency Heat

As stated, the major cause of Yin Deficiency is overwork without adequate rest. This burns out Yin and causes Yin Deficiency with symptoms of Dryness and Heat. This in turn gives rise to symptoms of Empty (or False) Heat.

Full or Wind Heat

All emotions lead to Heat. Thus a red-tipped tongue is the most reliable indicator of emotional stress.

Emotions, Stress and Qi Stagnation

Traditional Chinese Medicine posits seven emotions and each of these relates to one or more of the internal organs outlined in the Five Elements. Different exponents might describe these differently but the most important thing is to understand each emotion in excess can cause Qi Stagnation leading to Excess Heat and when this becomes more than our body can deal with, Yin Deficiency with Empty Heat symptoms occur.

Diet and Drinks

Excessive consumption of alcohol is a major source of Heat and the higher the alcohol content the more Heat it can cause. All kinds of meat are hot (or warm) but especially lamb and beef. All wild game with the exception of fish is hot. Finally, most spices are hot, including peppers, ginger, cumin, cloves, cinnamon, etc.

Environmental and Dietary Toxins

Toxins taken from food, drink and the environment which the body is unable to neutralize and discharge are a major cause of Heat. Symptoms corresponding to the internal organs leads us to what herbs to use to discharge or eliminate this Heat.

External Pathogenic factors penetrating to the Interior

Any external factor that is not expelled at the external stage and penetrates to the interior can change to Heat. Thus even Wind-Cold conditions not expelled from the surface through diaphoresis will change to Heat.

For example, a cold or flu not discharged via sweating can penetrate to the bronchioles or lungs causing bronchitis or pneumonia. This will happen if the symptoms are suppressed with fever-reducing drugs or antibiotics, for instance. We also might consider the phenomenon of Lyme disease or any feverish condition which starts out on the surface and penetrates and becomes internal Heat with a variety of debilitating symptoms manifesting in the joints and internal organs causing chronic fatigue and joint pains to be another example of this process.

The point to understand here is that pathogenic Heat, which in Western and Ayurvedic herbal medicine is largely considered a form of toxicity, is seen by Chinese medical theory as being caused by Qi Stagnation.

Yin Deficiency generates Heat caused by weakness and over taxation.  Yin Deficiency gives rise to “empty or false” Heat (true Heat being Excess Heat).

Following are two representative TCM formulas for Yin Deficiency and Yin Deficiency with Empty Heat:

Liu Wei Di Huang Wan – Rehmannia Six For Kidney Yin Deficiency

Prepared Rehmannia glutinosa (Shu di huang) – 20-25g

Cornus berries (Shan Zhu Yu) – 10-15g

Dioscorea batata (Shan Yao) 10-15g

Alisma (Zi Xie) – 9-12g

Moutan peony (Mu dan pi) – 6-9g

Poria mushroom (Fu ling)  - 9-12g



Prepared Rehmannia nourishes Yin, Jing and Blood

Cornus Berries nourish Liver and Kidney

Dioscorea tonifies the Spleen and Kidney

Alisma sedates the Kidney and causes turbidity to descend (diuretic)

Moutan sedates deficiency fire of the Liver

Fu Ling strengthens the Spleen and resolves dampness


The formula for Yin Deficiency with Heat (Zhi Bai Di Huang Wan) is the same with the addition of the Deficient Heat Clearing herbs

Anemarrhena (Zhi mu) – 6-9g

Phellodendron tree bark (Huang Bai) 6-9g

Both of these clear deficient Heat.

Portions or this article were inspired, extracted and paraphrased from Clinical Pearls by Giovanni Maciocia, one of the most highly respected practitioners of acupuncture and Chinese herbal medicine in Europe. Any errors uncovered in the text would be my own. Giovanni has an online education program here.

Heat is an extremely common condition in Traditional Chinese Medical Diagnosis.

In Ayurveda Heat can be described as pitta and there are two broad classifications: Pitta prakriti describes a constitutional predisposition of a normal pitta condition from birth. This is distinguished from Heat or inflammatory disease described as pitta vikruti which is an abnormal inflammatory or pitta condition.

Western herbalism doesn’t differentiate individuals from a constitutional predisposed state and describes only inflammation with little differentiation in terms of treatment, unless one delves into the older texts which describe excess heat as sthenic and deficient heat as asthenic.

In a personal correspondence with Giovanni Maciocia about this, he wanted to be sure that I emphasize that Heat is not the same as what is currently described as ‘inflammation.’ Inflammation is a kind of Heat, but the distinction is that while TCM “Heat” is caused by Qi Stagnation, it is broader in its implications while many types of inflammation such as those caused by bruising are caused by Blood Stagnation and is more confined to a specific area.

Today Western medicine and Western herbalists make much out of the notion of inflammation being an underlying cause of disease. Western medicine uses over the counter non-steroidal anti-inflammatory drugs (NSAIDs) along with more powerful drugs including antibiotics, antivirals and cortisone-type drugs. From the point of TCM, these may clear up the acute manifestation of inflammation but not the underlying condition of “Heat” in TCM terms. Thus one can have no inflammation but still have symptoms of TCM Heat or vice versa, symptoms of inflammation without TCM Heat and finally both inflammation and TCM Heat.

All of which begs the question, what is TCM “Heat”?

Any definition is bound to invite criticism but, let’s face it, while I practice Chinese medicine and regard it as the greatest gift of wisdom from the ancient world to contemporary society, I doubt whether I will ever be able to understand some of the TCM concepts of Chinese medicine with the same perspective and understanding that someone steeped in that culture from birth might have. So I’m a Western herbalist practicing Chinese Medicine as a part of a wider practice of herbal medicine which I call ‘Planetary.’ So here goes my definition of TCM “Heat:”

Heat according to Traditional Chinese Medicine is a general condition of hyperactivity that arises as a result of a fundamental Yin-Yang imbalance, which in Western terms would be an imbalance of homeostasis.

I know we don’t like to think of our bodies as an engine but I think mechanical engines were modeled after our body and the internal organs correspond to all of its internal parts. The basic idea is to take a small spark and amplify it so it moves a vehicle and that is what the gears, carburetor, motor cylinders, cooling system, etc. is designed to do.

So just as when we take a vehicle and run it on fast high gear using poor quality fuel, oil, lack of lubrication and cooling fluid, eventually depending on the integral strength of the material from which the engine parts are made, they will get hot, wear out and eventually break down altogether causing the engine to shut down.

Similarly, when we run the human body on poor quality food, air and water, and/or subject it to overwork and various forms of physical and emotional stress, the body will get hot, wear out and eventually break down.

The most vulnerable parts of our internal engine—the organs, hormones, etc.—go through a process first of Excess Heat, where ‘we give it all we’ve got’ so to speak. Then gradually the wear and tear begins to show on one or more of those internal organs until it begins to sputter out with heat generated from a weakening which is called Yin Deficiency first followed by symptoms of “empty Heat.”

Of course the engine or the body doesn’t shut down due to Heat alone, but as a result of the damage the Heat has done to the vulnerable internal organ(s).

The point to keep in mind here is that the cause of Heat and therefore the type of Heat in the last stages of Yin Deficiency is different from the Heat generated in the earlier stage of “Full or Excess” Heat.

Full or Excess Heat (tongue pictured at left) simply requires cooling everything down but Yin Deficient Heat requires lubrication and rebuilding. This is what Yin tonics in TCM do. While consuming herbs such as Echinacea or dandelion root, rhubarb, and cascara, more vegetables and fruits instead of red meat, and practicing quiet introspection will cool excess Heat, Yin Deficient Heat or Empty Heat requires nourishment, rest, oiling, and other things that will lubricate the dryness caused by prolonged excess.

To one who is not aware of this distinction, it would seem that Yin Deficient Heat is simply what arises as infections and inflammation and that the same old standbys (NSAIDs, antibiotics, cortisone) will do the trick but usually these don’t work in the long run, certainly not the same as they might if they were used to treat Excess Heat.

In extreme cases we recognize this type of Deficient Heat as any number of wasting diseases such as HIV, chronic hepatitis or TB. However one can be somewhat wasted from stress and overwork without having these or for that matter any clearly defined disease. Disease leading to death as a result of deficiency only occurs in the later stages of Yin Deficiency. Before this or during there are a number of other general symptoms of Yin Deficiency manifesting Empty Heat that a TCM doctor looks for such as:

  • a feeling of heat in the afternoon/evening
  • a dry mouth with a desire to drink in small sips
  • malar flush (red cheekbones)
  • dry throat at night
  • feeling of heat in the chest, palms and soles (called 5-palm heat).
  • Dry stools
  • Scanty dark urine
  • Floating and rapid pulse
  • Red tongue without a coat

An acknowledged ‘master’ of tongue diagnosis, Maciocia describes how a tongue that lacks a coating (pictured at right) and/or has scattered cracks is typical of Yin Deficiency. As described above, but requiring more experience to recognize, a Yin Deficiency pulse may be slightly rapid and thin or floating and empty. In other words, the pulse and tongue reflect Qi desperately struggling to maintain presence, or as some individuals suffering from nervous burn-out might describe it, just struggling to keep things together.

For practitioners who want to learn more about the different types of Heat in TCM and their respective treatment Chinese herbal and acupuncture treatments consult Giovanni’s excellent book, Clinical Pearls, published by Su Wen Press: http://www.giovanni-maciocia.com/books/english/clinicalpearls.html
Also check out Giovanni's online courses here: 

Stay tuned for Part 2 of this blog, which will discuss the etiology and herbal and other treatments for Heat and Yin Deficiency, published later this month!

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