Perhaps the most important topic to discuss with patients is the subject of diet /nutrition and its role in the healing process. This subject is also an area many clinicians feel uncomfortable handling and often neglect to confront.
One of the most important ideas for clinicians to grasp is the idea of moving away from what I term "partisan nutrition." In today's information overload media driven world, patients and clinicians alike are bombarded with conflicting nutritional information which is often presented with religious-like overtones.
This more often than not creates frustration rather than illumination. It's important that clinicians don't proselytize personal dietary beliefs to patients. Clinicians ideally should be a source of balanced education being able to explain to patients the pros and cons of the diverse array of dietary approaches.
One of the most important basic considerations for the clinician to take into account is the evaluation of food allergies or food sensitivities. This is a vast complex subject that cannot be completely addressed all in one article, but some important basic ideas can be conveyed.
At a minimum, the clinician should ascertain whether the patient has explored the issue of food allergies and food sensitivities. Targeting this area is often the most important foundation in which to build an effective herbal protocol. This area can be the taproot of a confusing storm of symptoms in which the clinician can become lost and over prescribe herbal formulas. Once the area of food allergies or intolerances is addressed, many chronic symptoms resolve and true underlying patterns emerge which can be resolved with simple herbal protocols. Once again, this is a complex area of discussion and clinicians should seek professional help as needed to help patients effectively target and resolve issues of food allergies and sensitivities.
Another simple area of patient focus is to find ways to stimulate the patient's interest in examining their food choices and guiding them into habits of preparing their own meals and minimizing processed foods. If we can get patients excited and interesting in food and the role nutrition can play in speeding up the healing process then we can see higher patient compliance in all therapeutic avenues. Preparing meals at home using simple unprocessed foods can be an important starting point for any dietary transformation; if the patient cannot be inspired at this level then more complex attempts at dietary modifications, even if clinically relevant, will fail due to poor patient compliance.
Yet another simple yet clinically powerful area of patient evaluation is for the clinician to evaluate the digestive capacity of the patient. In TCM, this would be the strength of the Spleen qi and in Ayurvedic medicine it would be the level of the digestive "fire " or Agni. In particular, Ayurveda expresses four levels of digestive capacity or Jatharagni:
1.) Manda: slow, sluggish , weak ( Kapha)
2.) Tikshana: sharp, excessive, fast, hot ( Pitta)
3.) Vishama: irregular, erratic, inconsistent (Vata)
4.) Sama: balanced
The clinician can evaluate the level of the patient along this scale and used appropriate measures to bring the digestive system back to a state of balance whereby herbal medicines can be adequately absorbed and utilized. One of the most important first steps in this process is having the patient eliminate processed foods from the diet, eat meals at regular intervals and teach the patient how to use simple spices to stimulate, cool, or regulate the digestive fire as needed based upon the clinical presentation.
Using such spices as cumin, coriander, cardamom, fennel, clove, turmeric, fenugreek, cayenne and black pepper can be exquisitely simple and act as "medicines" which help the digestive system return to the appropriate state of balance based upon the unique body time and pattern presentation of the patient. These spices can help the Spleen assimilate sticky Yin medicinals as well as prevent qi boosting medicinals from causing stagnation. It can also inspire patients to explore new tastes and view the kitchen as a sacred place of creativity and healing.
It's important for clinicians to explain to patients that herbs and food therapy are subtle medicines which work with the body to return the body to a state of balance. Both approaches can take time to effect change however when used in combination can create a complex synergy catalyzing the inherent healing power of the body.
Once patients see the effect of simple dietary changes they can start to feel empowered to take an active role in the healing process rather than just expecting pills and acupuncture needles to "magically" resolve their out of balance lifestyles . Even the most complex and effectively prescribed herbal medicines will fail if the patient's dietary habits are out of balance.
Clinicians should help convey the idea of the body as a dynamic field which can sow the seeds of health or disease. Herbs cannot be expected to flourish if the soil is inherently of poor quality. No amount of clean water or fertilizer can transform poor quality soil. However if the soil or "field" of the body is of good quality, then clean water and herbs can act as powerful catalysts for the manifestation of health.
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