the aging spleen

[Guest guest]

Bob

 

You have written in several places the the spleen declines in its function

significantly by the age of 35 in women (5X7 year cycles). You have also

written that by age 40, yin is half gone. since spleen xu and yin xu are

major factors in the disease process and both occur " normally " with aging,

does that not make age etiological in the disease process. Are you

saying that one can have spleen xu and yin xu due to aging, yet these

imbalances do not cause any morbidity? However if these imbalances are

caused by diet or emotion, they are pathological? Same spleen, same yin.

It would seem however they decline, pathology would result. It would seem

the only way to age gracefully is intervene in this process so it slows.

 

Eat easy to digest food, temper sexual activity are two common admonitions

to protect spleen and yin, respectively. If one does not do this, then

aging will lead to morbidity. However if one does do this, then one is

inherently accepting the idea that to live a long healthy life, one must

treat the decline of aging with special diet, lifestyle, exercise and

perhaps herbs that were not necessary in one's youth. this means that one

is rectifying a process that has diminished one's zang-fu functions. It

is splitting hairs as to whether we call this natural physiology or

pathology. the fact remains that something has gone awry and without

intervention of some sort, morbidity will occur.

 

So a person can eat a good diet and do everything else right and they will

still end up spleen xu and yin xu. this may be natural, but it still

sounds etiological to me. We can't reverse the etiology, but it is still

the cause of one's decline. And identifying this etiology allows us to

give advice that would be irrelevant to a young person. the likelihood

that severe taxation has lead to impotence in a young man is slim, but is

much greater in an old man. Ultimately one has to identify taxation as

present either way, but knowing aging will typically result in taxation is

etiological information. Perhaps you could call this demographic, but if

certain diseases almost always arise before a certain age, I would suggest

the correlation is probably more than more coincidental and there is some

causal relationship. Again, to reiterate, western gerontology does

believe morbidity and disease are built into aging. Everyone dies sick.

It just may not happen till your 100 years old if you live a healthy life.

 

 

Chinese Herbs

 

 

" Great spirits have always found violent opposition from mediocre

minds " -- Albert Einstein

[Guest guest]

 

 

Once again I think we have a semantic/translational issue here.

Sorry, but I'm trying to look at the meta-issue here.

 

If you use the term " etiology, " which I personally reserve for Western

medicine, then you might consider age as an etiological factor.

However, I understood that you were talking about age from the point

of view of Chinese medicine. In that case, the term is bing yin

(disease cause). As you know, we have three causes (internal,

external, and neither internal nor external). Because bing yin

includes the word bing, it refers to causes which cause disease.

Spleen vacuity and yin vacuity are not " diseases " (although, granted,

they are pathological states). Spleen vacuity and kidney vacuity are

zheng, patterns. The only two patterns which are simultaneously

considered bing yin or " disease causes " in CM are phlegm and blood

stasis, the so-called " secondary " disease causes.

 

Hopefully this clarifies where I'm coming from on all this. I'm trying

to see it the way I believe Chinese see it as evidenced by the way

they use their language. In other words, it goes back to the inherent

logic within the Chinese language (which is not the same as our logic

in English).

 

Bottom line, you can and perhaps even should (depending on the wishes

of the patient) treat the spleen vacuity and yin vacuity associated

with aging. I know I try to take care of these issues for/within

myself so that I can keep doing what I want to do. But that does not

make them " disease causes " or bing yin since CM considers them zheng,

not bing. In addition, CM also does not include aging per se as a

disease or bing. Age is a condition, an inevitable stage of life. As

you might know, I have been very interested in CM bing or disease

categorization and its clinical use for some time, and I know of no

Chinese language CM text, premodern or contemporary, book or article,

which includes age as a disease category. In comtemporary Chinese

medicine, you can talk about senile dementia, senile vaginitis, senile

this, and senile that, but age itself is not listed as a disease.

 

Bob

 

, <@i...>

wrote:

> Bob

>

> You have written in several places the the spleen declines in its

function

> significantly by the age of 35 in women (5X7 year cycles). You have

also

> written that by age 40, yin is half gone. since spleen xu and yin

xu are

> major factors in the disease process and both occur " normally " with

aging,

> does that not make age etiological in the disease process. Are

you

> saying that one can have spleen xu and yin xu due to aging, yet

these

> imbalances do not cause any morbidity? However if these imbalances

are

> caused by diet or emotion, they are pathological? Same spleen, same

yin.

> It would seem however they decline, pathology would result. It

would seem

> the only way to age gracefully is intervene in this process so it

slows.

>

> Eat easy to digest food, temper sexual activity are two common

admonitions

> to protect spleen and yin, respectively. If one does not do this,

then

> aging will lead to morbidity. However if one does do this, then one

is

> inherently accepting the idea that to live a long healthy life, one

must

> treat the decline of aging with special diet, lifestyle, exercise

and

> perhaps herbs that were not necessary in one's youth. this means

that one

> is rectifying a process that has diminished one's zang-fu functions.

It

> is splitting hairs as to whether we call this natural physiology or

> pathology. the fact remains that something has gone awry and

without

> intervention of some sort, morbidity will occur.

>

> So a person can eat a good diet and do everything else right and

they will

> still end up spleen xu and yin xu. this may be natural, but it

still

> sounds etiological to me. We can't reverse the etiology, but it is

still

> the cause of one's decline. And identifying this etiology allows us

to

> give advice that would be irrelevant to a young person. the

likelihood

> that severe taxation has lead to impotence in a young man is slim,

but is

> much greater in an old man. Ultimately one has to identify taxation

as

> present either way, but knowing aging will typically result in

taxation is

> etiological information. Perhaps you could call this demographic,

but if

> certain diseases almost always arise before a certain age, I would

suggest

> the correlation is probably more than more coincidental and there is

some

> causal relationship. Again, to reiterate, western gerontology does

> believe morbidity and disease are built into aging. Everyone dies

sick.

> It just may not happen till your 100 years old if you live a healthy

life.

>

>

> Chinese Herbs

>

> voice:

> fax:

>

> " Great spirits have always found violent opposition from mediocre

> minds " -- Albert Einstein

[Guest guest]

, " Bob Flaws " <

pemachophel2001> wrote:

 

Because bing yin

> includes the word bing, it refers to causes which cause disease.

> Spleen vacuity and yin vacuity are not " diseases " (although, granted,

> they are pathological states). Spleen vacuity and kidney vacuity are

> zheng, patterns.

 

But that does not

> make them " disease causes " or bing yin since CM considers them zheng,

> not bing.

 

I still must beg for clarity. What is the mediator between disease causes and

diseases? Is it not the pathomechanisms of the zang-fu organs? So we

would all agree that overeating of greasy food is considered a miscellaneous

cause of disease under diet. But greasy food or cold food or raw food injurs

the spleen and leads to dampness, both zheng or patterns. disease results

when the disease factors disrupt the zang fu. Disease factors do not cause

disease yet leave the zang fu unharmed. Or wind-cold (an exterior climatic

factor) invades the exterior, where it disrupts qi flow in the surface and the

lungs, causing the symptoms of cough and body aches. So all disease

factors cause zang fu imbalance which manifest as disease or at least

discomfort. Since aging also leads to zang fu imbalance and thence

morbidity, it seems to fit the same criteria. Perhaps the chinese did not think

of it this way for cultural rather than medical reasons.

 

Perhaps my point is being missed. I work in educating students, who may ask

why a particullar middle-aged patient has developed chronic dampheat

prostatitis in the first place despite taking such good care of himself. I

might

begin by saying that the spleen weakens with age and even food that was

once easily digested now produces dampness. So the student understands

that aging will inevitably lead to weak spleen and dampness if one does not

take special steps to avoid this (diet, exercise, etc.). Now the cure would be

perhaps the same if a young person exhibited such symptoms, so why call it

age related? Because one cannot cure age related changes, just slow or

mitigate them. so prognosis is dependent on whether age is a factor or not. I

really think this is very semantical. We can say technically age is not a bing

yin and not use it in this semantic way. But we cannot deny its role in

disease.

 

[Guest guest]

Todd -

you wrote: Perhaps my point is being missed. I work in

educating students, who may ask

why a particullar middle-aged patient has developed chronic dampheat

 

prostatitis in the first place despite taking such good care of

himself. I might

begin by saying that the spleen weakens with age and even food that was

 

once easily digested now produces dampness. So the student

understands

that aging will inevitably lead to weak spleen and dampness if one does

not

take special steps to avoid this (diet, exercise, etc.).

but, my question to students always is: Why did this particular

patient develop this particular pattern. Because not all aging men

will develop chronic damp-heat prostatis so there must be something else

that is causing this individual to tend in this direction - it is not

just that aging will lead to weak spleen and dampness. This, I

think is where students will most often fall short when doing a

diagnosis. They do not think far enough but are simply satisfied

with saying that there is damp heat - but the real question is why.

 

Marnae

At 10:07 PM 4/23/2003 +0000, you wrote:

--- In

, " Bob Flaws " <

pemachophel2001> wrote:

Because bing yin

> includes the word bing, it refers to causes which cause disease.

 

> Spleen vacuity and yin vacuity are not " diseases "

(although, granted,

> they are pathological states). Spleen vacuity and kidney vacuity are

 

> zheng, patterns.

But that does not

> make them " disease causes " or bing yin since CM considers

them zheng,

> not bing.

I still must beg for clarity. What is the mediator between disease

causes and

diseases? Is it not the pathomechanisms of the zang-fu

organs? So we

would all agree that overeating of greasy food is considered a

miscellaneous

cause of disease under diet. But greasy food or cold food or raw

food injurs

the spleen and leads to dampness, both zheng or patterns. disease

results

when the disease factors disrupt the zang fu. Disease factors do

not cause

disease yet leave the zang fu unharmed. Or wind-cold (an exterior

climatic

factor) invades the exterior, where it disrupts qi flow in the surface

and the

lungs, causing the symptoms of cough and body aches. So all disease

 

factors cause zang fu imbalance which manifest as disease or at least

 

discomfort. Since aging also leads to zang fu imbalance and thence

 

morbidity, it seems to fit the same criteria. Perhaps the chinese

did not think

of it this way for cultural rather than medical reasons.

Perhaps my point is being missed. I work in educating students, who

may ask

why a particullar middle-aged patient has developed chronic dampheat

 

prostatitis in the first place despite taking such good care of

himself. I might

begin by saying that the spleen weakens with age and even food that was

 

once easily digested now produces dampness. So the student

understands

that aging will inevitably lead to weak spleen and dampness if one does

not

take special steps to avoid this (diet, exercise, etc.). Now the

cure would be

perhaps the same if a young person exhibited such symptoms, so why call

it

age related? Because one cannot cure age related changes, just slow

or

mitigate them. so prognosis is dependent on whether age is a factor

or not. I

really think this is very semantical. We can say technically age is

not a bing

yin and not use it in this semantic way. But we cannot deny its

role in disease.

 

[Guest guest]

Bottom line,

>>>The other bottom line is: many TCM dr say that because a patient is this or that age certain patterns/diseases a prevalent and therefore medicines are added to a formula. so call it what you want age is often taken into account in prescribing a formula,which is the only bottom line that matters

alon

[Guest guest]

Bottom line,

>>>The other bottom line is: many TCM dr say that because a patient is this or that age certain patterns/diseases a prevalent and therefore medicines are added to a formula. so call it what you want age is often taken into account in prescribing a formula,which is the only bottom line that matters

 

alon

 

Alon,

I agree with you. Doing things because of synchronicity is a Taoist tradition. Bob, Cara and I as well as Todd's colleague did not agree with age as an etiology, but rather as synchronicity. You plant in the spring and harvest in the fall. You are not fixing or correcting anything by doing this. WM has only a few such traditions like giving vaccinations during youth to prevent disease. I'm not sure if that quite qualifies. But as you say, age may not be a cause of imbalance, but certain imbalances are more common occurrences at certain ages. CM seems to have many more traditions that go with time of life or time of year, time of season and time of day.

Regarding Angela Wu, her office is close to you on the south side of Clement Street near 8th Avenue in SF. With people moving out of San Francisco, it's ever easier to park on Clement Street. Also, people seem to be avoiding the Chinese restaurants around there (SARS?), so they need our patronage. :-)

Emmanuel Segmen

 

[Guest guest]

WM has only a few such traditions like giving vaccinations during youth to prevent disease. I'm not sure if that quite qualifies.

>>>If you look at the tradition of nutritional medicine etc. WM does have a lot that goes with aging taking into account. Also even in more traditional WM there is much that does attempt to manipulate aging, certainly the estrogen fiasco is one

alon

[Guest guest]

WM has only a few such traditions like giving vaccinations during youth to prevent disease. I'm not sure if that quite qualifies.

>>>If you look at the tradition of nutritional medicine etc. WM does have a lot that goes with aging taking into account. Also even in more traditional WM there is much that does attempt to manipulate aging, certainly the estrogen fiasco is one

alon

 

Right, Traditional WM does indeed. I've never heard it called that. My great grandmother was a Greek herbalist living in Macedonia. My mother helped her pick herbs from the local forest.

 

I was actually trying not to mention the "estrogen fiasco" but I did think of it with a chuckle.

 

Emmanuel Segmen

[Guest guest]

I really think this is very semantical. We can say technically age is

not a bing yin and not use it in this semantic way. But we cannot

deny its role in disease.

 

 

 

I completely agree with this last statement. I even teach a DL class

exactly on this through BPI titled, " Age & The Practice of Chinese

Gynecology in the West. " I believe that aging is a huge factor in

understanding disease mechanisms in specific patients and can very

much help in pattern discrimination. I just don't think we need to add

aging as a bing yin to the system of CM.

 

This is not because I think the current bing yin are necessarily

categorically complete and sacrosanct. If you have read my earler

work, you know I am open to the idea of continuous evolution in CM. In

the early and mid-80s, I wrote several articles about the expansion of

bing yin in modern circumstances. However, in retrospect another

couple of decades out, I don't think my ideas were as clever and well

founded as I believed at the time.

 

Bob

[Guest guest]

I think most practitioners consider age as an important factor in treating patients. But when we consider health as the "smooth flow of qi and blood and the balance of yin and yang," someone's age would not necessarily be a main factor in the disease mechanism. Someone of strong constitution and essence at age 60 may have half as much yin/yang/qi/blood as he did at age 20, but that still may be more than many 20 year olds who have poor constitutions. So long as the limited amount of yin/yang are in balance to each other and so long as the qi and blood are flowing smoothly, disease should not arise. With that being said, how many 60 year olds have this proper balance? In today's day and age I think it rare. Sixty year olds have had many more years living out of balance and when you couple that with the decrease in yin/yang and the obstructed flow of qi/blood, chronic and serious diseases may result. I don't think that makes age an etiological factor. I think it makes the amount of time living out of balance, coupled with the person's constitution/essence, and the activities that cause the imbalance, the factor.

 

Ross

Message: 1Thu, 24 Apr 2003 14:44:56 -0000"Bob Flaws" Re: the aging spleenI really think this is very semantical. We can say technically age is not a bing yin and not use it in this semantic way. But we cannot deny its role in disease.I completely agree with this last statement. I even teach a DL class exactly on this through BPI titled, "Age & The Practice of Chinese Gynecology in the West." I believe that aging is a huge factor in understanding disease mechanisms in specific patients and can very much help in pattern discrimination. I just don't think we need to add aging as a bing yin to the system of CM. This is not because I think the current bing yin are necessarily categorically complete and sacrosanct. If you have read my earler work, you know I am open to the idea of continuous evolution in CM. In the early and mid-80s, I wrote several articles about the expansion of bing yin in modern circumstances. However, in retrospect another couple of decades out, I don't think my ideas were as clever and well founded as I believed at the time. BobRoss Rosen, JD, MSTOM, LAc (NY), CA (NJ), Dipl Ac & CH (NCCAOM)

President, Center for Acupuncture and Herbal Medicine, PA/PC

 

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