Environmental Medicine

 

This is a theory I came up with when I first started studying Chinese Medicine, inspired by financial inaccessibility to modern comforts; like a kitchen table, a couch, bed, or chairs. My only two items of furniture were a futon I put on the floor (which later became infested with mold and had to be discarded), and a short coffee table.

empty room
  This is about what my apartment looked like except I had fashionably pink carpeting.


futon folded into couch with frame

I just want to say before I get started that I am not against furniture, I now own a futon that is raised off of the ground for proper mold prevention. This article is more to make you aware of how our immediate environment can impact our health and well being in ways we take for granted.



It is imperative for doctors to take environmental factors into account if they are to have success with a wide variety of patients. What started off as a grain of sand will add up to a vast desert wasteland if it goes unattended to.

people crawling through desert wasteland




Development and deterioration


Most people agree that in life we go through a period of development, in our bodies and mental faculties, from birth through to adulthood. We then plateau and gradually decline in our bodies and minds, until our bodies finally return to the earth.

 

new born baby crying in doctor's arms cross shaped grave marker
Development and decline   From birth to the earth

 

But for some, there is a period of decline that takes place beginning as early as childhood.

 

Most toddlers have no problem sitting on there haunches, sitting cross legged, sitting on their heels, and lying on the floor. They go from sitting on the floor to standing with very little difficulty, and their backs are strong enough to keep their spine in perfect alignment.

baby sitting on floor upright
  Kids sit on the floor with perfect posture quite easily

 

kid sitting uncomfortably on couch

As they develop through childhood, less hip and ankle flexibility, less leg and lower back strength makes that trip from standing to the floor and from the floor to standing again more strenuous and less attractive.

 

When they do attempt to sit without a backrest (and often even with a back rest), their lumbar region which should exhibit a posteriorly concave (lordotic) curve has instead a posteriorly convex (kyphotic) curve, and there is often excess forward cradling of their heads.

 

man sitting with convex curve of lumbar spine

lumbar vertebrae with normal concave lordotic curve
Abnormal kyphotic curve of lumbar vertebrae while sitting   Normal lordotic curve of lumbar vertebrae

 

Mind, body, recliners

 

girl sitting sick with pillow behind head

Chairs, couches, recliners, and benches are fundamentally a tool for convalescence, care of the sick, and support for the aged.

Furniture which supports our bodies functions primarily for convalescence
 

 

 

If you look closely at these items, their primary function is to make it easier to stand from sitting, easier to sit from standing, and easier to sit when sitting (because sitting is such hard work).

Diagram showing distance between a perso's butt and their feet while standing
  Furniture provides an artificial seat to bridge the unholy expanse between nature's seat and your feet



couple sitting with adjustable bed holding them in sitting position

They provide support for our backs so we don't have to perform the grueling task of holding up our bodies on our own accord (Oh dear God, anything, please, just don't make me hold up my own body weight).

Furniture holds our bodies up so we don't have to  



They allow us to get up and sit down without burdensomely strong and flexible legs.

chicken legs
 
Chicken legs won't stop you thanks to furniture



Old couple sitting on couch

If you have the company of the elderly at your household, it is very rude not to offer them a seat. If the seat is too low, many will have trouble getting up again. (Yeah, I know it's rude regardless of the age of the visitor not to offer them a seat, but it's ESPECIALLY RUDE when the visitors in question are elderly).

Would you keep them standing?  



Those with bad backs, spinal disorders, weakness or paralysis in lower limbs, and the elderly tend to have trouble getting out of chairs (and sometimes toilets) if they are too low or lack armrests.

old guy with can sitting on low seat



old woman with a walker

Eventually some require new types of furniture to support them. It may be a walker, a cane, a wheel chair, or a motorized scooter.



On crowded buses, young are expected to give up their seat for the handicapped and elderly. It is polite for those with a healthy body to offer up their creature comforts to those with feeble or sick bodies.

crowded bus



illustrated girl sick in bed

All of this creates a subconscious association in our minds, attaching furniture to illness, age, and weakness.

Our minds have joined furniture and disease in eternal matrimony. Most people are O.K. with letting kids sleep on the floor, but who would try to keep a sick child out of bed?  



At the same instance, we have a conscious association of furniture with comfort, prosperity (especially for expensive furniture), and convenience.

expensive looking couch



Bum sitting on stoop

Those without furniture are viewed as poor (in the case of panhandlers squatting along the street), or misfortunate (in the case of the guy standing on the bus who envies those that are sitting).





Adaptation

 

Our bodies adapt to stressors as well as comforts. Too much stress can break us, but too much comfort can soften us.

 

For small children it is more convenient to sit on the floor than to sit on furniture because the latter often involves some athleticism and climbing skills. But they try too anyway, because the adults around them are doing it, and they have a drive to experience the world, as well as learn socially acceptable behaviors.

kids climbing onto couch
  Using furniture actually requires more effort than staying on the floor for children

 

child sitting on floor with good posture

Getting by without too much furniture shouldn't be hard to do; we develop that way very early in life.

 

 

Gradually with increases in vertical stature, sitting on furniture becomes more convenient and it is practiced more than sitting on the floor.

Yao Ming at basketball game standing next to shorter referee

 

Our bodies are very efficient and tend to do the least possible work to maintain life. So when we don't use the muscles and flexibility required to sit low with no artificial support for our backs, we eventually lose them.

 

This practice doesn't only affect our bodies, but our minds, it affects our perception of ourselves. Remember that there is an association between furniture and weakness, disease, and age. And remember as well that furniture is desirable (sitting on the bus is better than standing).

 

So what we are telling ourselves is that weakness, disease, and aging is desirable. It is so desirable that we spend countless hours and money to get the perfect items (designer chairs and couches) to promote the aging and weakening of our bodies.

furniture showroom
  We actually spend our hard earned money and valuable time to accumulate objects that promote the weakening of our bodies

 

And we eventually accept this perception because our bodies adapt, and it becomes very uncomfortable indeed to go without furniture.

 

Parallel universe

 

guy sitting back looking out window at city below with respirator under shirt

Imagine a world where breathing with an artificial respirator is a sign of affluence, and using the natural power of your lungs and diaphragm for respiration is associated with poverty and hardship.

If circumstances were such, you may feel sorry for those forced to breathe without assistance
 

 

Electric vehicles and people movers are prized more highly than the natural power of our legs for getting from point A to point B.

lady on motorized mobility scooter
  Why walk around the house when you can drive?

 

Nurse washing man in high tech bathtub

Servants wash our bodies because it is much too much to ask to strain ourselves with self-grooming.

 

lady with electrodes on her head

Electric devices are attached to our bodies to constantly monitor our blood pressure, heart rate, respiration because the mental faculties required to self regulate our autonomic nervous system are just too difficult to develop.

vital signs monitor

 

We run on a glorified hamster wheel because it's just too dangerous outside, we may trip over a pinecone or get close-lined by an aggressive tree.

hamster running in wheel
lady running on treadmill
Hamster wheel Hamster wheel, glorified

 

dazed guy holding pole attached to iv bag

Sacks of life deliver nourishment directly into our blood stream because chewing is for the birds. Who would want to subject their beautiful teeth to decay and their fresh breath to onions and garlic?




Chemicals alter our perceptions and feelings because the world is oh so hard; controlling our thoughts, emotions, and perceptions naturally is inconceivable.

prozac bottle spilling pills out onto the counter
two guys smiling wide with missing teeth and a mouthful of brownies
Drugs Smile, you're on drugs

 

 

 

Devices hold up our heads or backs, keep our legs from having to bend too far, make it convenient to get up or down without too much effort.

woman lying upright with help of craftmatic adjustable bed

 

Most of these things will hopefully never take place on a large scale in day to day life, but some unfortunately already have. Only some of these practices have gained great foothold outside of the setting of a hospital, but imagine if you were raised in an environment where all of these things were commonplace.

 

guy wearing respirator

What would it be like if in order to truly relax everyone had to breathe with the assistance of a respirator?

 

They all carry a double edged sword, in that while they provide an outlet to perform functions we are unable to perform (or are too lazy to perform), if used long term, our innate abilities to self regulate deteriorate. And if they carry with them a sign of desirability or affluence, then sickness, weakness, and age, become desirable.

double edged sword lying on red cloth
  Luxury has a price, and not just economically

 

Don't get me wrong, these practices and devices are crucial for the care of the sick. But what price do we pay when we care for the healthy as though they were sick? What is the cost when self regulation is lost?

 

Pai Mei from Kill Bill vol 2

Self regulation is easy. Many of our self regulating abilities are available at a very early age. But instead of enhancing these abilities as our bodies and minds develop, we allow them to fall by the way side due to their lack of importance in our culture.

Self regulation
 

 

 

Power of the mind

 

One of the easiest ways to demonstrate the power of the mind is with the self fulfilling prophecy. This is where our expectations for a certain outcome influence our behavior and wind up leading to that very outcome. So what happens is what we expect to happen.

 

news paper that reads

This can happen with the stock market. If everyone expects the stock market to crash, they take their money out to prevent too large of a loss. But by taking their money out, selling their stocks, it leads to a declining stock value, and can result in a crash.

 

A runner with no hope of winning the race will run slower. Why should he exert himself if he is going to lose anyway?

guy straining himself on a trail run

 

irish bar scene

A man that sees himself as socially awkward is less likely to pick up the girl at the bar, because he already expects to fail. He may not even try.

 

 

Chris Farley was excellent at demonstrating the self fulfilling prophecy on Saturday Night Live, when he would interview someone famous and be so concerned with screwing up that he kept screwing up.

Chris Farley interviewing Paul McCartney on SNL

 

American soldiers in combat in Iraq

War can be a self fulfilling prophecy. If you attack people you believe to be your enemies, they will then be your enemies, whether you believe it or not.

 

There is an upside to the self fulfilling prophecy, in that if you expect success, health, and peace, these things are more likely to manifest.

 

big white pill that says placebo on it

Another demonstration of the power of mind is the placebo effect. It is widely accepted in the scientific community that a person's expectations and faith in the treatment or medicine they receive will affect the outcome. Sometimes pain can be reduced or eliminated with fake surgery or sugar pills.

 

Through biofeedback and relaxation techniques people can learn to consciously alter their blood pressure, heart rate, and temperature.

girl with biofeedback electrodes connected to head and hand

 

man pushing down on woman's out stretched arm

With muscle testing one person holds up his arm while another pushes down. A person that meditates on strength in his own body right before the test tests much stronger than the same person that meditates on the weakness of his own body right before the test.

 

Our expectations and preconceptions play a large part in how things turn out, be it good or bad. What is the result of surrounding ourselves with items whose primary function is support for the weak, sick, and dependent? How do we begin to see ourselves? If we have a preconception of ourselves as weak, sick, and dependent, how are we going to turn out?

 

 

Other cultures

 

Why are Kenyans strong runners? Is it because they are genetically superior? That may be a small piece of the puzzle, but the bottom line is that anyone that eats, sleeps, and breathes running is going to become a stronger runner than they otherwise would.

Kenyan runner about to win race

 

 

squattie pottie

Why is it so easy for people in Japan to sit on the floor during meals, sit at very low tables, and use squattie potties? What is more likely, that they are genetically superior in the sitting department, or that their lifestyle promotes those abilities?

Why is it easier for people that live in Japan to use a squattie pottie?  

 

Is it any surprise that tribal, outdoor cultures are better at living in the outdoors than domesticated, indoor cultures?

tribal native guiding canoe through water

 

WWFs ultimate warrior posing for camera

I'm not trying to bash American culture. Each culture has its strong and weak points, making it hard to say any culture is better off overall. But flexibility is a necessity in a world that is constantly changing, and that we are constantly learning about.

Each culture has its own strengths and weaknesses
 

 

 

One of the fundamental strengths of American culture is its melting pot ability to adapt given new circumstances and information. Why not take important lessons from other cultures and incorporate them into our own lives to promote health?

woman with american flag skirt stirring pot full of people from different countries

 

In the places a culture promotes strength, strength will tend to result. It is not hard to predict the result when weakness, sickness, and dependency are promoted.

 

 

Environmental medicine

 

Relationships

 

One of the main reasons Chinese Medicine can succeed where Western Medicine fails is that skilled Traditional Chinese Medicine (TCM) practitioners take the whole picture into account when they are treating patients. That doesn't mean that they only look at the whole pattern inside a patient's body, but they look at environmental influences on their disease, as well as environmental influences on the course of treatment.

 

sausage bacon egg cheese breakfast on biscuit

One of the simple ways this is done is with relationships. At the basic level it is simple to see how relationships can affect the course of disease. If the doctor recommends that you should cut out all high fat and cholesterol foods, but your family insists that they eat bacon and cheesecake for every meal you are going to have a tough time.

The family gets what the family wants  

 

If you need to start an exercise program, but all your friends want you to sit on the couch and drink beer, then it will be harder than if you had athletic friends (admittedly, some athletic types enjoy this age old pastime). Quitting drinking or smoking is much more difficult if you hang out with drinkers and smokers.

people at party hitting the beer bong
  "Guy's, I'm not going to drink tonight"



old man in hospital bed

Disease in one member of the family can lead to disease in other members. This is not limited to contagious diseases. Caring for a family member with a chronic illness can lead to depression, anxiety, high blood pressure, back pain, and other ailments in the caretaker.

Even care of non-contagious patients can lead to disease in the caretaker
 



An abusive and unsupportive spouse and/or friend(s) can lead to emotional, mental, and physical syndromes.

sad girl with head down



crazy and upset baby

Relationships can be especially problematic in the case of Chinese Medicine in America. Because it is not a widely accepted theraputic method, people may be viewed at the very best, alternative, and at the very worst, crazy, for enlisting the help of an acupuncturist/herbalist and following his/her advice.

When following medical advice results in this reaction by family members, it may result in a lapse or even complete cessation of compliance
 



Family members may complain that herbal remedies are stinking up the house. Kids may think there parents are crazy for going to the ‘witch doctor' to get needles stuck in their bodies.

girl holding nose
  Family members may complain that herbal remedies stink



fairy

A skilled TCM practitioner should have techniques and methods at his disposal to get around these obstacles, and a sound understanding of anatomy and physiology. Herbal pills can be used to eliminate foul odors. He must explain the logic of such methodologies so skeptics can see that therapies are based on sound principles rather than esoteric fairy dust.

A skilled practitioner must show there is more to his methods than fantasy and fairy dust



Seasons

 

kid getting flu shot

One of the most fundamental ways environment relates to disease in Chinese Medicine is the seasons. This principle is almost completely disregarded in Western Medicine other than justifying a yearly flu shot or explaining the influence of pollen on hay fever and sinus allergies.

There is much more to seasonal medicine than flu shots and Claritin  

 

 

Every patient in Chinese Medicine should be broken down in terms of yin and yang. Yin and yang is a dichotomy that can be used to interpret everything in the world. I will discuss in greater detail the many manifestations of yin and yang in a later article about nutritional and medicinal supplements, but for now a simple way of looking at these concepts is with hot and cold.

yin and yang symbol with palm of hand and needles
 
Every disease and every patient should viewed through the yin and yang dichotomy




pot of water boiling with steam above pot

If boiling water is yang then ice is yin. If the thermometer outside reads 120 degrees Fahrenheit that is yang, 34 degrees Fahrenheit is yin.

man with ice on face and winter clothing
If boiling water is yang
  Then ice is yin



Yin and yang make only make sense together, in comparison, there is no object you can point to and say that is absolute yang or absolute yin. So 34 degrees Fahrenheit would be yang if it was compared to 60 degrees below zero.


This is where the complication starts, because there are no objective instruments to measure these concepts, they require interpretation. This is why western medicine doesn't use these ideas, because once you travel beyond the realm of measurable data you've overstepped scientific boundaries and entered the realm of the artist.

balance with yin in one scale and yang in the other
  Science says if you can't measure it, it doesn't exist



Van Gough portrait of guy with pipe

Everyone knows artists can't be doctors.

 

Every person can be broken down in terms of hot and cold and every disease can be broken down in terms of hot and cold.

hot and cold faucets

 

 

A hot person (this means temperature, not physical assets) tends to wear less clothing (unless they are shy), prefers the air conditioning to the heater, and prefers iced tea over hot tea.

Ice T, rapper
 
Hot people prefer Ice T over Hot T

 

Capital letter T on fire

A cold person uses more blankets at night, shivers if they forget their jacket, and is very grateful if you offer them hot chocolate.

Cold people choose Hot T instead of Ice T  

 

For you acupuncturists/ acupuncture students who are chomping at the bit for the full yin/ yang discussion on false cold, true heat, or false heat, true cold; look for these concepts in my future article about supplements. It is true that hot and cold are not always immediately apparent, making yin and yang harder to establish, but techniques are available for differentiation even in more complicated cases. But for brevity's sake in this article I will do my best to keep things simple.

 

girl with sweaty face

Hot diseases may involve a high temperature, profuse sweating, sore throat, redness and inflammation, and an inability for the patient to sit still or lie still.

Sweating can be indicative of a hot disease
 

 

Cold diseases may include shivering, frigid hands and feet, relief with hot showers or liquids, and pallor of the skin.

man covering up with blankets, uncomfortable expression
  Chills can indicate a cold disease

 

inspector looking through spyglass

None of these symptoms by themselves are necessary or sufficient to say that the patient is truly hot or cold (truly yang or yin), but taken together they provide clues with which we can make a reasonable hypothesis.

Clues must be viewed together to come to a sound conclusion
 

 

 

Every disease can be broken down in terms of hot and cold, which is why just saying a person has a given disease doesn't mean the diagnosis is complete. There is hot diabetes and cold diabetes, hot flu and cold flu, hot IBS and cold IBS, hot hypertension and cold hypertension, hot cancer and cold cancer, etc. Because medicines and therapies are also hot or cold, every disease must be broken down in terms of these components if treatments are to be successful.

 

winter scene snow on rock

So now I'll get back to the seasons. In the winter it tends to be cold, and in the summer it tends to be hot. In the winter people typically get more cold diseases and in the summer people typically get more hot diseases.

In the winter people get more cold diseases
 

 

 

There is some overlap here, because people in the winter may spend more time around the heater and get a hot disease, and people in the summer may drink too many margaritas and get a cold disease.

Tropical beach
  In the summer people get more hot diseases

 

The way this relates to medicine is that a person with a hot constitution who gets a cold disease in the summer will likely recover quickly because the heat counterbalances the cold. But a person with a cold constitution who gets a cold disease in the winter will be more challenging to treat, because too many factors are promoting their disease.

 

woman holding tissue up to nose

People with hot constitutions are more sensitive to hot seasons, the weather acts synergistically with their body type, and this principle accounts for many seasonal allergies. Provide them with herbs, medicines, therapies, and education on how to reduce heat, and low and behold their sensitivity to pollen is reduced.

People with hot constitutions get seasonal allergies when weather gets warm, those cold constitutions seasonal allergies come when weather gets cold
 

 

 

Seasonal harmony

 

So how do we act in a manner that puts us in harmony with the seasons? Typically the best thing to do is practice warming activities in the winter and cooling activities in the summer. This will minimize seasonal diseases and afflictions. Most people do this already to some extent, dressing warmly in the winter and putting on fewer clothes in the summer.

girl bundled in winter clothes covering all but eyes
  Most people, barring the judgement impaired, dress according to the seasons

 

mascot red lion posing on hot day

Sometimes career choice makes this impossible, however.

 

Diet is of utmost importance. This aspect of living in harmony with the seasons often gets ignored. Warming foods such as ginger, scallions, cinnamon, nutmeg, cloves, coffee, and black tea should be delegated to days when it is cold. Cooling foods such as mint, green tea, (most) raw vegetables, cucumbers, pears, and cranberries should be consumed when it is hot.

 

Dogmatic dieters get themselves into trouble by following health crazes beyond the season that they made sense in. Eating nothing but raw vegetables and salad for ‘detoxification' and limiting fluid intake to green tea for its antioxidant properties may be good for a while. But do that consecutively for three winters in a row and don't be surprised when you have diarrhea, stomach pain, acid reflux, cold limbs, sore joints, dizziness, and anxiety.

salad
  Salad only does not necessarily equal healthy

 

steak grilled on a plate

The strict meat, grease, hot sauce, and cola diet works in the winter time. But when summer rolls around a few times, it's high time for anger management, high blood pressure, constipation and/or dysentery, and frequent bloody noses.

mmm.... Summer BBQ

 

 

The actual physical temperature of the food is also important. Someone who drinks six cold beers and eats a gallon of ice cream on a cold winter night is just begging for a stomach ache, headache, nausea, and joint pain. There is no such thing as a beer jacket; cold vodka on a cold Russian night only leads to a Russian Popsicle in the morning.

body mummified due to freezing
  His beer jacket wasn't warm enough

 

girls out for a night on the town posing with skimpy clothes

Dress to impress with only a hard liquor to keep you warm on a cold winter night if you're willing to pay the price with menstrual cramping, PMS, and potential infertility (or maybe pregnancy depending on how your night goes).

 

 

Environment is not absolute

 

So this article covered three environmental factors; culture, relationships, seasons, and their interplay with health and well being. Please note there are more aspects to each of these variables than I covered here, but I just covered a few basic examples to make the point that there is more to disease than just what goes on inside our bodies (namely, what goes on outside our bodies).

 

Remember that it is the relationship between yin and yang that is important; neither make sense without the other. It is the interplay between a person and their environment that is tantamount. The environment itself has no power to improve or impair health.

 

It is the interaction between a person and their environment that affects health. These above rules apply for an average Joe, but not everyone is average, and neither is everyone named Joe.

 

eskimo woman smiling

If you take an Eskimo to California in the winter time where the temperature can drop to a brutal 45 degrees Fahrenheit, he is not going to shiver. He may in fact feel too warm and take off his coat. If he eats an ice cream cone and drinks a glass of ice water it's not going to hurt him. At the same time a severely emaciated cancer patient may be fine drinking cup after cup of hot chai tea even when the thermometer outside reads 120 degrees fahrenheit.

Your idea of cold and hers are not the same (unless you're her)
 

 

A person with a very hot constitution may be fine spending 20 years eating nothing but raw vegetables, and a person with a colder constitution may actually experience health benefits from long-term adherence to the Atkins diet.

 

old woman without teeth smoking with eyes pointed in opposite directions

Strong genetics may allow a smoker to live to the ripe old age of 100.

 

A person with genetically strong and flexible hips, lower back, and ankles may remain so in spite of a lifetime of dependence on furniture and other modern conveniences.

woman sitting with legs crossed in lotus position

 

Marve from Sin City

Someone who has a naturally tough, impenetrable mind may be unmoved by denigrating family and friends.

 

It is the responsibility of the doctor/ health care practitioner to make sense of these interactions, and provide insight on an individual basis as to which environmental influences will be harmful, which will be helpful, and which are unimportant.

 

A doctor who ignores these influences may get away with it for a while, but eventually this obliviousness will come back to haunt him. A comedian may get booed off of the stage if he references Jewish stereotypes to an audience full of sons and daughters of concentration camp survivors. The environment must always be considered.

 

Don't assume I want you to throw away all of your furniture to make yourself stronger. Just like the environment interacts with the individual, different environmental aspects interact with each other.

 

When I had no furniture, I didn't have a lot of guests over, because going from standing to sitting on nature's seat was far too arduous a journey, and who was I to not provide a plush cushiony sofa for their sitting enjoyment? So the health benefits of my living quarters were cancelled out by the health detriments that come with irritated friends and guests.

silhouette of lord of the rings characters walking along path
  Are you prepared for the perilous journey from the glutes to the boots?

 

Some people if they immediately give up furniture will actually injure themselves because their bodies have grown accustomed to it.

 

Practice these rules in moderation because too much rigidity causes more problems than it solves. Learn to see the good and bad in all things. If you have to stand waiting for your table at that fine restaurant, or can't afford to purchase all the modern inconveniences that your friends are so fond of, it's not necessarily such a bad thing. Enjoy the use of your lower limbs.

 

Make an appointment at Roots of Eastern Medicine Acupuncture Clinic. Leave no stone unturned.

Benjamin Krieg, L.Ac.

www.acuroots.com

www.connectivetissueacceleration.com

www.rootsofeasternmedicine.com