One of the most important concepts in TCM is the influence of the seasons and climate on the health of the patient. Classical texts such as the Shang Han Lun and the Jin Gui Yao Lue discuss in detail the influence of cold and heat on the human body and on the development of patterns of disharmony. I educate patients on this concept extensively and believe it is a vital concept clinicians should not ignore.
The hot months can cause significant damage to your patients' qi, blood, fluids and yin. Entire books have been written on these clinical concerns. Today, I focus primarily on qi and yin deficiencies, and the potential issues of stagnation which can result from living in hot environments for extended periods of time. Two important TCM patent medicines in such conditions are Sheng Mai San (Generate the Pulse Powder) and Yue Ju Wan (Escape Restraint Pill). Both patent medicines are relatively simple formulas; however, they have wide applicability in the clinical setting when dealing with heat-related conditions.
Sheng Mai San
This formula consists of three herbal medicinals: Ren Shen, Mai Men Dong and Wu Wei Zi, used to target qi and yin deficiency due to excessive loss of sweat and fluids, which leads to the dissipation of heart / lung qi and yin. I use this formula extensively in the summer months for patients who work outside, athletes, and patients who may already have qi and yin deficiencies, which are exacerbated during the summer season.
Sheng Mai San is extremely easy to digest and does not typically cause qi stagnation or digestive issues, as some heavy, cloying yin tonics may cause. I often use this formula in simple tea form, substituting Xi Yang Shen for Ren Shen, as American ginseng has a cooler energy and nourishes fluids as well.
Sheng Mai San can easily be added to other patent medicines if more complicated underlying patterns are also present. In addition to supplementing qi and nourishing yin, one of the many benefits of this elegant formula is that it also has the action of calming the nervous system.
Yue Ju Wan
This simple, effective formula targets the "five stagnations" of damp, blood, qi, heat, and food. Consisting of the herbs Cang Zhu, Chuan Xiong, Xiang Fu, Zhi Zi, and Shen Qu, this patent medicine can be a wonderful addition to the clinical arsenal during the hot summer months of grilling outdoors with heavy, greasy foods and busy, stressful, active "holiday" schedules.
Heavier, higher protein / higher fat diets are not uncommon during the summer vacation months, which can often cause qi / blood stagnation, as well as excess heat and dampness. I often recommend patients have this formula on hand during vacation trips and when they anticipate eating heavier, high-protein, fatty foods.
This formula is also an excellent addition for patients suffering from spleen / liver disharmony, particularly if typical formulas such as Xiao Yao Wan or Jia Wei Xiao Yao Wan are not completely resolving the particular patterns of disharmony. Yue Ju Wan can also be used prior to or concomitantly with formulas with nourish the yin, which may be heavy and cloying due to the yin-enriching medicinals. If the "five stagnations" are moving freely throughout the body, it is much less likely for the summer heat to cause significant issues.
A Must-Have Summer Food to Add to Your Formula Recommendations
The simple food I always encourage patients to consume during the hot summer months is ... organic apples. According to TCM nutrition principles, apples are cooling and enter the spleen, stomach, lung, large intestine, and lung channels. The flavor is sweet / sour, and the actions are to tonify qi and nourish yin. Apples also have the special properties of clearing heat and eliminating toxins.
During the hot summer months, I often encourage patients to eat at least one and ideally two large organic apples daily. In many ways, organic apples have the same actions as the patent medicines Sheng Mai San and Yue Ju Wan!
Author's Note: Clinicians interested in deeper discussions on this topic should examine the important contemporary text Warm Pathogen Diseases: A Clinical Guide, by Guohui Liu. Have a safe and cool summer!
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