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Archive for the ‘Traditional Chinese Medicine and fertility’ tag

Infertility and TCM Part 14: Did Qi Bo Know Best?

By David Kreiner MD

April 15th, 2015 at 11:39 am

photo: stuart miles/

Traditional Chinese Medicine (TCM) evolved over thousands of years as evidenced by several ancient written works including the oldest medical textbook in the history of the world, the Huang-Di Nei Jing (Yellow Emperor’s Cannon of Internal Medicine), dating back to between 300 and 200 BCE.

The book is named for Huang Di, the Yellow Emperor, who lived between 2700 and 2600 BCE.  The legend is that it is a record of the emperor’s conversations with his distinguished physician, Qi Bo.  The Huang-Di Nei Jing consists of 162 articles divided into theory and practice.  The section on theory involves the relationships among the internal organs, the sense organs, and the brain dealing with the concepts of yin and yang as applied to medicine.

In TCM according to the Huang-Di Nei Jing, the yin and yang principle proposes that the bodily organs are interdependent and support each other in harmony.  Disease is defined as a loss of this state of balance both within and among the organs.  Treatment with TCM has always been based on the restoration of the body’s natural harmony with a rebalancing of all the organs.

In all likelihood, the Huang-Di Nei Jing represents a compilation of works drawn from the experience of many TCM leaders over the course of hundreds, if not thousands, of years.  It is reminiscent of the Jewish Talmud which likewise represents contributions from thousands of Rabbis over the course of hundreds of years.  Also, in a fashion similar to the study of TCM, contemporary Jewish scholars study and follow the Talmud much as it was originally written.

The second section of the Huang-Di Nei Jing is a manual on the practice of acupuncture.  Today, this book continues to be used as a reference by contemporary TCM practitioners.

The internal organs are believed according to TCM to be connected by a system of acupuncture points organized along channels (also referred to as meridians) throughout the body.  Each point regulates an aspect of the functional activity related to its channel or associated organ, or sometimes some other channel or organ it may also ultimately connect with or relate to.  Acupuncture points are areas on the surface of the body where the Qi (the body’s life energy) may be accessed as it traverses through one of these channels.  By stimulating or reducing (suppressing or dispersing) at the acupuncture point, the TCM practitioner can regulate the flow of Qi in the channel and/or to a particular organ.

In TCM, pathology may exist secondary to a stagnation of this flow of Qi which disrupts the function of an organ not receiving its normal Qi flow.  Qi may be deficient in which case the treatment would be to increase the Qi in the body and tonify affected organs.  Other pathologies may exist based on excess or deficiency of fluids, heat and blood.  Stagnant blood flow may cause disease, as can excess cold or heat, all of which can affect the flow of Qi as well as the channels and organs in the body.

TCM practitioners often utilize herbs to assist in restoring the harmony in the body and expelling the pathogens which include heat (including summer heat), cold, dampness, dryness and wind which we think of in modern medicine as viruses, bacteria, fungi etc.

In addition to acupuncture, the TCM practitioner may utilize moxibustion which is the application of heat applied to the skin using a vehicle that may include the use of topical herbs.

Cupping, the application of small glass cups or bamboo jars as suction devices on the skin is yet another technique utilized to improve the flow of Qi through the channels in the body.  It is also used to release toxins, clear blockages of Qi and blood, as well as relax muscles.  It can encourage blood flow and sedate the nervous system.  It has been used for cellulite reduction as well as to clear congestion from the common cold or to help patients with asthma.

Modern application of TCM… though based on ancient science, philosophy, and techniques… still resembles that which was performed over 2000 years ago.  I think that… despite its lack of Western scientific explanation, basis, and justification… it remains a viable medical option because of the evidence of cure and palliation that it has brought to so many over the millennia.

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Do you believe there is a place for Eastern medicine practices, blended with Western medicine? Interested in learning more? Post any questions here for Dr. Kreiner.




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TCM and Infertility Part 6: TCM Pathogens of Wind, Cold, Heat, Dampness, Dryness, Phlegm and Emotion

By David Kreiner MD

April 18th, 2014 at 10:27 pm


credit: stuart miles/

Welcome, to my new world where I often feel like Robert A. Heinlein’s “Stranger in a Strange Land”.  

UnIike Heinlein’s protagonist, I am not accustomed to eating the bodies of the dead (though some natural holistic purists may consider this act the ultimate in sustainability.)  But to the previously unexposed who’ve been brought up from a Traditional Chinese Medicine (TCM) perspective, perhaps some of the Western Medical physicians’ practices may appear a bit barbaric.

In our recent Western Medical history such practices as lobotomy for psychological disorders, certain hard core diet therapies including high risk bowel resection surgery, and nearly routine hysterectomies for perimenopausal women would be considered potentially dangerous malpractice today.  However, if we thought drastic high-risk unnecessary medicine were a thing of the past, then consider the fact that excessive plastic surgery and some other unnecessary current Western therapies are more common now and have resulted in occasional deaths and disfigurement. 

Greed is a strong motivator and is one of the ills pervading our society… and the health care field has not been immune to its seduction.  Greed too often factors into determining the direction of treatment for individuals today.  Corporate greed is the reason insurance companies fail to cover many in need of health care and force physicians to see more patients than they have time to care for.  It is also a reason some providers order and perform some expensive and potentially risky tests and procedures.  

Western Medicine has had its share of iatrogenic disasters, yet I have seen many ill or infertile patients reap the benefits as a result of modern Western Medicine.  Even so, I as well as other physicians am left without answers all too often to explain or cure some of the complaints we hear from our patients.  For this reason I study TCM to learn its explanations and its treatments for some of these common ailments and complaints that elude the expertise of the Western physician.

I have been involved in the health care field for 37 years and I am quite comfortable communicating about pathogens such as bacteria and viruses and parasites and about pathophysiologic processes such as atherosclerotic heart disease, hypertension, diabetes mellitus, pelvic inflammatory disease and endometriosis to name a few.   Today, as I study Traditional Chinese Medicine, I now read and speak an additional language.  

The pathogens of TCM are Wind, Cold, Heat, Summer Heat, Dryness and Dampness, Phlegm and an individual’s emotions.  They may attack from outside the body such as wind cold (the equivalent to the common viral cold) or internally as a result of a disharmony among one or more of the organ systems.  Emotions such as Grief and sadness, anger, fear, worry and even joy according to TCM can be pathogenic when carried to an excess and lead to a disharmony of an organ system or to a blockage of the flow of Qi which can result in dampness and other pathologic events or pathogens. 

These pathogens are the “root” cause of the individual’s disharmony resulting in the manifestations or symptoms.  For example, complaints such as fever, cough, sore throat, vomiting, diarrhea, constipation, bloating, etc. ., are the result of these pathogens.  Interestingly, ancient Chinese texts refer to insects or bugs as being carried by the wind as a cause of some syndromes such as the Wind Cold referred to earlier.

There are also multiple ways to categorize and classify pathologic syndromes. They may be classified as cold or hot, internal or external, excessive or deficient or yin or yang conditions.  They may be identified as affecting one of the organ systems which are defined more based on their physiologic role from a traditional Chinese perspective rather than by their Western anatomic and physiologic identity that we learn in medical school.  There are four different layers of pathogenic attack from the most superficial to the deepest and most internal. There are even other theories of disease which may be used to classify pathology usually described as a disharmony affecting one or more organ systems.

The treatment prescription is based on the identified syndrome(s) and may be geared towards eliminating the root cause of the disease as well as the clinical manifestations and associated symptoms.  One may use acupuncture to tonify a particular weakened organ or Qi, yin or yang.  Acupuncture can eliminate heat or cold from one or more of the channels of Qi.  Or there may be excess body fluids in the form of edema, dampness or phlegm that needs to be eliminated.  Chinese herbal prescriptions are often given as an adjunct to the acupuncture to improve the efficacy of an individual’s treatment.

It does sound bizarre to this Western-trained physician, but I am impressed that the science of TCM has lasted thousands of years.  I imagine there must be something to this needling patients to modify the Qi in the body that has some benefit to the patients’ health and well-being.

I look forward to new adventures and greater understanding as I become more familiar navigating this strange land.

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Do you believe that TCM pathogens could be impacting your fertility?



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TCM and Fertility: The Importance of Vital Substances and Maintaining Balance

By David Kreiner MD

March 20th, 2014 at 2:07 pm


image courtesy of stuart miles/free digital

Traditional Chinese Medicine (TCM) has presented such a challenge to my Western scientific perspective that I neglected to define the basic principles on which TCM is based. 


TCM, and life itself, according to Chinese tradition which developed over the past three thousand years starts with the vital substances, Qi and Essence, in addition to blood and body fluids.  Our human physiological functioning is dependent on these vital substances which the body attempts to maintain in balance between Yin and Yang.  The Qi and Essence, blood and body fluids will interact and perform their essential roles throughout the body dependent on the Zang-Fu and “extraordinary” organs and the states of Yin and Yang while traveling through vessels, channels, and branches that interconnect with each other.

The concept of Qi comes from the Chinese Taoist philosophy that has been described as a “life force” but is actually an aggregate of ideas that we Western thinkers like to separate to better understand.  To our way of thinking it likely is a form of energy, or electric potential that crosses cell membranes as it traverses from one part of the body to another.  Chinese tradition identifies many different forms of Qi each with different functions affecting physiology and life.  The acupuncturist studies the channels through which Qi flows in the body to modify its flow for a particular purpose… whether to eliminate pain or improve an individual’s health, both of which may be impacted by some pathology of Qi level or flow.

Essence (Jing) is considered one of the three treasures of TCM, along with Qi and Shen (spirit).  Jing is stored in the kidneys according to TCM and nourishes and fuels the body.  There is Prenatal Essence which is supposedly inherited much like DNA and cannot be renewed.  It is responsible for an individual’s constitution and congenital illness. Postnatal Essence can be replenished by food, herbs, acupuncture, or exercise such as T’ai Chi.  Total Essence is made up of both Prenatal and Postnatal Essence and is responsible for growth, development, and reproduction.  Effects of aging may be caused by a deficiency or deterioration of one’s Essence.

In Chinese philosophy, the concept of Yin and Yang is used to describe opposite yet complementary forces that are both interdependent and interconnected and give rise to each other.  Yin and Yang interact in a dynamic way.  Whenever one quality reaches its peak, it will naturally transform into the other.  In TCM, good health is directly related to the balance between Yin and Yang qualities within oneself. If Yin and Yang become unbalanced, one of the qualities is considered be either deficient or in excess… which can lead to illness and disease.

The traditional Chinese concept of human organs, known as Zang-Fu and “extraordinary organs”, are not primarily based on anatomical considerations.  They instead are defined as functional entities with a general location in the upper, middle, or lower Jiao separated by the diaphragm and the umbilicus.  The three Jiao (San Jiao) together is considered a functional organ in TCM and… in addition to separating the other organs into three cavities including chest, upper abdomen and lower abdomen… it functions in the transport of Qi and body fluids.  These Zang-Fu and additional “extraordinary” organs are interconnected with each other through channels of Qi in addition to vessels containing blood and body fluids.  As a result, a problem in one organ can affect the functioning of another.

TCM differs from Western Medicine mostly in its holistic approach as compared to our Western reductionist way of scientific thinking.  Disease and illness according to TCM is a result of a disharmony in the functions of Yin and Yang, Qi and its pathways or meridians, the organs (Zang-Fu and “extraordinary”), Essence, and/or the interaction between the individual and his/her environment.  Therapy is based on which disharmony pattern is identified and may include behavioral modifications including diet and exercise, treatments including herbs, acupuncture, and moxibustion, as well as other interventions.


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What TCM concept explained above is most fascinating to you? Which would you like to learn more about?



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