Heart Disease has been linked to so many things: smoking, diet, stress, alcohol, cholesterol, apnea, insomnia, lack of exercise, certain medications, kidney/liver failure, gingivitis. Is there anything it is NOT related to these days? Hence the most common response to this topic is, very naturally: FEAR.
To understand heart disease, you merely need to understand the mechanism that underlies the entire process.
- Artery/vessels get assaulted by “objects” in blood
- Body lays down cholesterol plaques to protect the smooth muscle
- Process repeats, usually at sharp turning junctures or splits
- Plaque builds up
- Either the thrombus bursts/is thrown into an embolus or via buildup…
- Blockage occurs
- Heart muscle is starved of O2
- Heart muscle dies = Myocardial Infarcation = Heart Attack
- Or other CVA (same process).
This is the process.
Understanding how we got there is very complex in both biomedicine and Chinese Medicine, but perhaps a bit less complex in TCM, and the treatment and recipe for healing more clear.
First, we need to look at etiology. In TCM, anything that comes and stays in the body is a “pathogen” or “xie Qi.” Something that attacks Qi. What Qi? In this case, primarily the Liver Qi and the Heart Qi; secondarily Kidney and Jing (essence or vital) Qi.
The start ALWAYS involves stagnation of Liver Qi (excepting a person born with heart defects which is an Jing-essence problem). A stressful life will necessitate a stressful diet and high blood pressure because the sympathetic nervous system is ratcheted up tight (hence the Liver Qi stasis). In this case, we are talking mostly about the state of a) cravings, b) rabbit breathing, c) dehydration habits, d) mania or manic-like workoholism, e) obsession, pensiveness, and anxiety, f) ultimately uncontrollable Hypertension.
The arteries and vessels are muscles innervated by nerves (channels), and they respond to stress the same way we down: with irritability, and clamping down. This by nature raises the blood pressure, because the subconscious assumption is that we are “under imminent threat.” From what? Does it matter? Does the unconscious body have any clue or ability to rationalize between our boss yelling at us, our diet being full of toxicity, or our worries about bills? Not really. The conscious mind does, but it has to spend a large percentage of time through meditation or lifestyle alterations to change the message the subconscious mind is habitually sending to the body about the “state of things.”
After all, the Liver Qi is controlled by the subconscious (Hun) and this means the lower CNS (cerebellum, reticular, pyramidal, endocrine and thalamus systems). The conscious cortex has only the ability to make alterations, not the job of running the body. It must consciously adjust the nervous system, but the real controls are in the hands of the subconscious mind.
So when you spend only 5 minutes calming down – and watching TV is not the same as meditation (zoning out vs. zoning in) – you’re fighting the subconscious for overall “advertising time.” If anything, you’re advertising to your body’s mind that you care more about fantasy and stress than you do about health and happiness. Therefore, it’s more of the “batten down the hatches” energy that got you stressed to start with. FIGHT OR FLIGHT.
The increased tension, whether it came from smoking, emotions, alcohol, food, stress, etc…, will raise your BP and heart rate, and when it does this the objects (and nowadays constant toxins) will scoot along at an accelerated rate, cutting you. The old “torture by 1000 cuts” is literally happening inside you in this state.
There are 3 basic types of Liver Stasis:
- Mental Stasis – nervous system related
- Organ stasis – or as TCM says, LV Blood Stasis (with flank pain being the sign)
- Diaphragm stasis – or as TCM says the “Mansion of Blood” and is related to respiratory lock caused by habitual shallow breathing or trunkal obesity.
All of these can and do (with time) combine, and usually do when you have diabetic/obese states. Once that happens, you have a very dangerous outflow of possibilities long before you have any “heart disease.”
For starters, Liver Qi Stasis does not stop Liver Qi from flowing. The liver organ metabolizes nonstop, all the time, that’s its function. When it is not freely flowing through the channels (and its enzymes not reaching their intended recipients), then the result is a constant generation of heat.
Now, there are two rates this can happen: slow, or very fast (but alternating). The difference is sort of like the difference between a Hawaiian volcano and Vesuvius. The slow heat is the harder to detect because the hypertension is minor, the signs are minor. The blood congeals, and liver spots form on the arms and back, and the face gets redder everyday, maybe even a “drunkard’s nose” starts to appear. The hair turns gray early on. The person gets more irascible and stern with age, and their tendons get harder faster than average. They have ear ringing – at first loud and high pitched, then later like crickets or rushing water.
They have decline of adrenal function, and tend to wear out more quickly, and digestive issues set in, so they take to dietary crutches like coffee and energy drinks, or sugar cravings, which wear out the Earth (pancreas) faster, which leads to further energetic decline and weaker immunity.
At this point the difficulty isn’t about the liver stasis it’s about the collection of dampness, blood stasis, and systemic phlegm (shown left). The net result being multiple heart blocks, DVT, etc… and without intervention, eventually complete CVA attack (stroke or MI).
This process can happen anywhere from 20 to 50 years, but the net result is still the same pattern, it just depended on how much Jing they had, versus how fast they used Qi, and how much time they spent offsetting this habit. Usually it’s familial as in the nervous system is already ratcheted a bit tighter than average and the habit of overwork is taught from parent to parent as well as most eating habits; also the food is chosen based on innate wealth.
Prognosis for this class is actually pretty good if they recognize the signs and take steps. For one, meditation is highly effective in reducing blood pressure. Secondly, they can make dietary changes and lifestyle changes that avoid the issues. Usually losing weight will eliminate most of the ancillary problems, and detoxification will finish off the rest. Finally they can more easily appreciate the destressing of TCM treatments, massage, hiking, meditation, etc… and avoid the issues.
One thing here is very important to discuss in treatment. Can they exercise? Depends on the stage. If they are deficient the answer is no. At least not with cardiovascular. The method is too severe, the risk too great, and the gain not enough. They must have herbs and acupuncture and maybe even meds. If they are not yet deficient to a severe degree where the Jing-essence is taxed and the Wei (immune system) is still intact, then actually cardio is exactly the type of anti-thought based exercise , if done sparingly and not daily, that would help lower blood pressure and lose weight.
It all depends on the person.
The second form of Liver Heat is Fire flaming Upwards… this causes Heart heat and even heart Fire, and is usually seen with eruptions of anger, acid reflux and ulcers, red tongue, red eyes, dizziness, deviated face or tongue (heart fire and “liver wind”), balding, liver spots on the face or cancers even, intense personality, hyperactive drives for food, sex, drink, and risky behaviors, investments, or other life-threatening events; angina and cardiac pain may or may not be present, depending upon their age, sex, and channel flow. The Fire not only quickly cooks the dampness and blood into a tarry phlegm, it carries it up into the head, and maybe instead of a massive and instantly death causing heart attack they might have a stroke. The hypertension is SEVERE, upwards of 180/100 or more. And it cannot seem to be sequestered by medication, and definitely exercise is out of the question because of the risk of instant death.
Liver Fire is a problem that starts inside the liver organ and releases enzymes that basically attack the body and raise blood pressure, increasing the flow towards the head and creating more tension.
This condition’s prognosis is more difficult and depends entirely upon compliance and, more or less, karma (choice+destiny). If the person resigns themselves to this state, it is very hard to change their mind and alter their actions. And unfortunately the restrictions needed seem almost unfair, especially since they may have been born more susceptible or somewhat “fated” to heart disease.
But nevertheless, herbalism combined with four or five adjunctive therapies, including life saving medications can turn the tide… but only if the person themselves believes they can live longer. They have to want to take the herbs and do the activities and manage their nervous system and liver’s health.
The worst part about this process, is unfortunately in 2/3-3/4 of the population it is not as straight forward (however complicated it’s been) but complicated by any number of issues:
- Systemic dampness due to Spleen/Earth Qi deficiency (often GERD)
- Or even fluid metabolism issues like edema, CHF
- Or diabetes
- Or Kidney Qi, Yin, or Yang or Yin & Yang deficiency meaning kidney failure
- Alcoholism, which is difficult enough to treat psychoanalytically; but now causing habitual Liver Fire and dampness (fatty liver) it becoems very difficult.
- Smoking, which introduces more toxins to insult the vessels
- Or cause cancer, which takes advantage of the lack of circulation in the lymph system
- Or causes more fire which makes the heart disease more progressive
- Or the treatments of cancer – chemo and radiation – which cause Fire-Toxicity locally or weaken Wei Qi circulation
- Or surgery for cancers which create more blood stasis when already we are heading to Heart Blood Stasis
- Or constipation, dysuria, or dysmenorrhagia which complicate the treatment because they are so severe you have to herbally treat those first before you can deal with the hypertension, diabetes, or Qi deficiencies
- Or any number of habits which have become ingrained and sources of confidence eaters and give hopelessness to the patient leading to Qi deficiency; so then you have to treat the lifestyle/habits and teach new outlooks on life AND treat the psychiatrics and only minimally treat the problem.
- Cold-heat complexes which block Qi flow and inhibit potency of acupuncture
The point being that it is far better to catch the process in the early stages of the game, than later. Unfortunately most of the focus seems to be in the later stages of the game. Until education on the true mechanisms and prevention of Heart Disease are disseminated to everyone, and in every health class, nursing school, med school, etc… and until we take seriously the effects of our Western Culture upon the issue, it is very likely we will continue to fight the problem from the wrong end; and very likely continue to lose.