Chai Hu, cox-2

March 10, 2003

Brain, Todd and All,

Despite the fact that I speak fluent biochemistry and physiology and have an abiding interest in the actions of Chinese medicine, the area of perhaps least interest to me is how newly characterized phytochemicals of Chinese herbs act on known regulatory enzymes of human physiology. I have to deal with this day in and day out, and frankly I feel it misses the point of standing at the confluence of these two rivers: Western concepts of physiology and Chinese medicine. I'm looking for much bigger game. To suggest that Chinese medicine has all the power of Western medicine in a pharmacological sense, to me is an unnecessary insult to Chinese medicine. When I was a child learning long division, I was convinced that this practice was so exquisitely difficult and complex that my electrical/chemical engineer father might not know about it. He was wonderfully patient and genuinely interested as I explained it to him. I hope we can all be so patiently interested in our children's development.

Chinese medicine has so much to teach a physiologist about first principles, that I'll share a little of my interest with you for you to see if you are also intrigued. One interest involves some simple observations. If you administer opiates like morphine to a patient, you discover that the opiate receptors reduce in a reaction called receptor-down syndrome. You need to use more and more opiates on fewer and fewer receptors to get the same effect. This leads to addictions. If you engage in a joyful activity like a morning beach run, tai chi in a lovely park, or playing some beautiful and uplifting music, you get a sense of well being with an attendant outflow of endorphins, our own opiates. Sometimes the opiate outflow is so strong by the second half of my run that I can't feel small injuries to my legs when running through sharp edged brush. What's intriguing is that there's a receptor-up syndrome so that over the years, the sense of well being comes earlier and earlier whether it's running, meditation or playing music. The marathoner Frank Shorter was being tested for aerobic physiological factors, and it was noted that he had an endorphin surge just by stepping on to the treadmill.

Physiology graduate students often spend their first year figuring out what is "stress" as an idea in physiology. Partly the confusion is that stress is first of all just an increased metabolic rate of a tissue. It could be stress from a joyful run at the beach, and this leads to increased depth of nighttime sleep, increased outflow of growth hormone, and increased liver function and liver secretion of somatomedins which are the growth hormones for the rest of the body. Or the stress could be due to trauma, a bad cold, a terrible argument with a significant other, or just some laborious and troublesome work. This would lead to an increased outflow of ACTH and cortisol which would inhibit deep sleep, inhibit growth hormone output and inhibit liver self repair and liver secretion of somatomedins.

So where does Chinese medicine fit in? To me tonic formulas act like and support the "good stress" of joyful exercise. Liver formulas like Xiao Yao Wan gets the liver to self repair despite daytime experiences of "bad stress". To my knowledge nothing in Bu Zhong Yi Qi Tang nor in Xai Yao Wan act on a molecular level to mimic growth hormone or somatomedins. If they did, they would injure that very homeostasis. That's the problem with administering growth hormone. It ruins the body's ability to synthesize and regulate its own synthesis of growth hormone among other problems. Activities like joyful exercise or tai chi increases this function as does Bu Zhong Yi Qi Tang. The research I was instructed to read when working at various herb companies showed me that Bu Zhong Yi Qi Tang acted like exercise, but you had to exercise to get the effect. All of the research I've seen does not imply a molecular pharmacological action. What is implied are higher order systemic or global actions that then can be directed up, down, more deeply, more superficially, and so on.

I observe that Bu Zhong Yi Qi Tang is not just a soup of phytochemicals, but rather a well formed medical instrument that has it's own integrity. It acts in large, global ways. This forces me to look at the physiology of good stress as compared to bad stress. What is the physiology of wakefulness and the physiology of sleep? Bu Zhong Yi Qi Tang is maximizing the effects of my wakeful exercise which itself has a special cocktail of hormones and neurotransmitters. And this daytime maximizing then maximizes the nighttime cocktail of growth hormones and somatomedins so that the heavy lifting of tissue growth and repair can happen. This would include memory consolidation which also involves an increase of neural connections in cerebral association areas. Often a musician will wake up in the morning able to play a difficult piece of music that was frustrating on just the previous day.

This vaguely frames my interests without writing an entire textbook here. But don't worry, I'm still intrigued as to how a Chai Hu molecular marker might affect cox-2 (cyclooxygenase production of anaphylactic and inflammatory chemicals). While I recognize that this is where the current "light" of science is shining, I don't sense that this is where the big game, the new paradigms of physiology, will be found. And you can bet that it will take some new paradigms in physiology for Western scientists to begin to "see" Chinese medicine. It is the same as when my studies in long division as a child were not enough for me to "see" how my father's engineering mind was able to work. I'm sensing and betting that Chinese medicine will eventually redirect the light for physiologists like me to look at and find more global themes which will make our own science much more powerful. At least enough to start to see Chinese medicine.

In gratitude for your patient reading,

Emmanuel Segmen

March 10, 2003

Emmanuel,

As usual, it is a breath of fresh air to read your posts. You are

someone who shares my point of view but is more eloquent in the realm

of biochemistry and physiology than myself.

I am also looking for bigger game. We need to look past the

molecular issues of isolated alkaloids on receptor sites (without

ignoring the challenge when it comes) to the bigger issues of how

complex medicinals in compounded prescriptions interact with human

beings.

When we isolate alkaloids or other active substances, and study or

market them, we are just making new pharmaceutical drugs. It is a

different ball game. We cannot compete with the drug industry, just

create our own realm to work and play in. Hopefully, it will

compliment the pharmaceutical world, but if not, should we roll over

and play dead?

On Monday, March 10, 2003, at 07:52 PM, Emmanuel Segmen wrote:

> Brain, Todd and All,

> Despite the fact that I speak fluent biochemistry and physiology

> and have an abiding interest in the actions of Chinese medicine, the

> area of perhaps least interest to me is how newly characterized

> phytochemicals of Chinese herbs act on known regulatory enzymes of

> human physiology. I have to deal with this day in and day out, and

> frankly I feel it misses the point of standing at the confluence of

> these two rivers: Western concepts of physiology and Chinese

> medicine. I'm looking for much bigger game. To suggest that Chinese

> medicine has all the power of Western medicine in a pharmacological

> sense, to me is an unnecessary insult to Chinese medicine. When I was

> a child learning long division, I was convinced that this practice was

> so exquisitely difficult and complex that my electrical/chemical

> engineer father might not know about it. He was wonderfully patient

> and genuinely interested as I explained it to him. I hope we can all

> be so patiently interested in our children's development.

March 10, 2003

In supportive response to Emmanuel, I'd like to quote a book I highly

recommend on genomics, called " The Delphic Boat " by Antoine Danchin, a

French geneticist. The " Delphic Boat " is a boat that. over time, has

its planks rot and gradually replaced. Eventually, the original planks

are gone, but the boat looks the same. Is this the same boat? Yes, I

recognize it. But nothing remains from the beginning! Except the

information that created it. If we examine the planks we can say they

are pine or oak, but it doesn't tell us much about the boat.. .

especially since the original planks are gone!

So, Mr. Danchin states that " the boat is not the material it is made

from, but something else, much more interesting, which organizes the

material of the plans: the boat is the relationship between the planks.

Similarly, the study of life should never be restricted to objects,

but must look into their relationships. "

As with the genome, so with medicine. For me, Chinese medicine's

great strength lies in its understanding of relationships between

phenomena inside and outside the self, and how these phenomena are

connected and interact with each other. Global interactions of

medicinal prescriptions with the complexity of the human being is one

of these relationships.

On Monday, March 10, 2003, at 07:52 PM, Emmanuel Segmen wrote:

> I observe that Bu Zhong Yi Qi Tang is not just a soup of

> phytochemicals, but rather a well formed medical instrument that has

> it's own integrity. It acts in large, global ways.

March 10, 2003

Thank you, Z'ev,

Your poetic response is gracious. Indeed, the human body turns over most of its own substance within just a few months. I'll be keeping a clear visual eye to see how the planks of Chinese medicine fit into human physiology and vice versa.

Emmanuel Segmen

-

Monday, March 10, 2003 9:23 PM

Re: Re: Chai Hu, cox-2

In supportive response to Emmanuel, I'd like to quote a book I highly recommend on genomics, called "The Delphic Boat" by Antoine Danchin, a French geneticist. The "Delphic Boat" is a boat that. over time, has its planks rot and gradually replaced. Eventually, the original planks are gone, but the boat looks the same. Is this the same boat? Yes, I recognize it. But nothing remains from the beginning! Except the information that created it. If we examine the planks we can say they are pine or oak, but it doesn't tell us much about the boat.. . especially since the original planks are gone!So, Mr. Danchin states that "the boat is not the material it is made from, but something else, much more interesting, which organizes the material of the plans: the boat is the relationship between the planks. Similarly, the study of life should never be restricted to objects, but must look into their relationships."As with the genome, so with medicine. For me, Chinese medicine's great strength lies in its understanding of relationships between phenomena inside and outside the self, and how these phenomena are connected and interact with each other. Global interactions of medicinal prescriptions with the complexity of the human being is one of these relationships.On Monday, March 10, 2003, at 07:52 PM, Emmanuel Segmen wrote:

I observe that Bu Zhong Yi Qi Tang is not just a soup of phytochemicals, but rather a well formed medical instrument that has it's own integrity. It acts in large, global ways.

March 11, 2003

In a message dated 3/10/2003 10:25:35 PM US Mountain Standard Time, zrosenbe writes:

So, Mr. Danchin states that "the boat is not the material it is made

from, but something else, much more interesting, which organizes the

material of the plans: the boat is the relationship between the planks.

Similarly, the study of life should never be restricted to objects,

but must look into their relationships."

As with the genome, so with medicine. For me, Chinese medicine's

great strength lies in its understanding of relationships between

phenomena inside and outside the self, and how these phenomena are

connected and interact with each other. Global interactions of

medicinal prescriptions with the complexity of the human being is one

of these relationships.

Well said. I have come up with an analogy I tell my patients about seeing the body as a team, for example, a football team. If a football team is not playing well, not winning, how would you go about deciding why and what to do about it? You could analyze each player's health and wellbeing individually, which is analogous to what doctors do with liver enzyme tests and such, but this may lead to the common medically confusing situation where the patient's medical tests all come back normal, but they still feel awful. The individual players in the analogy may be just fine, but they're not communicating well with their teammates, not working together. To me, what makes Chinese medicine unique is its ability to read the lines of communication between organ and other body energy systems and see how they're doing as well as detect individual system flaws or damage.

What I don't know is how to translate this into Western testing to see if doctors and Western-type scientists can somehow emulate this mindset and information set. If there ever is some way to do this, this seems to me the only way to test and describe how herbs work in a complex living system. Any thoughts?

Joseph Garner