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Digestion and nutrition in ayurveda and Chinese medicine
6 Digestion and nutrition in ayurveda and Chinese medicine Chapter Objectives 1. Introduce the biomedical aspects of digestive tract in descending order, including the upper and lower sections and the small and large intestine 2. Introduce tongue diagnosis according to Ayurvedic medicine including the rasas/ flavors and their effects on health 3. Introduce the traditional Chinese medicine tongue diagnosis based on the five zang organs, their flavors on the tongue and the effects on health
The digestive tract in descending order
Blausen.com staff (2014). Medical gallery of Blausen Medical 2014. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002e4436. Perspectives of Ayurveda in Integrative Cardiovascular Chinese Medicine for Patient Compliance. https://doi.org/10.1016/B978-0-12-817570-5.00006-2 Copyright © 2020 Elsevier Inc. All rights reserved.
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Chapter 6 Digestion and nutrition in ayurveda and Chinese medicine
Upper gastrointestinal tract
Lower gastrointestinal tract
Mouth
Small intestine
Pharynx Esophagus Stomach Duodenum
Large intestine
Small Large intestine intestine Duodenum Cecum and appendix Jejunum Ascending colon Ileum Transverse colon Left colic flexure Descending colon Sigmoid colon Rectum Anus
Ayurvedic medicine Ayurveda Dosh - Tongue Red Medium size tengue with green coating
Pitta Vata
Narrow tongue with cracks & pale uneven brown coating
Kapha
Larger tongue with white coating
© 2019 Anika Niambi Al-Shura. Published by Elsevier Inc. All rights reserved
Six flavors or rasas: • Sweet • Sour • Salty • Bitter • Pungent • Astringent
Chapter 6 Digestion and nutrition in ayurveda and Chinese medicine
Sweet Wheat, rice, dairy, cereals, dates, pumpkins, maple syrup, and licorice root • Decreases/balances vata and pitta • Increases kapha • Water and earth • Grounding and nourishing • Promotes longevity, strength, and healthy bodily fluids and tissues • Promotes gain weight • Heavy, oily, and moist • Slow digestion
Sour Lemon, vinegars, pickled and fermented foods, tamarind, and wine • Decreases/balances vata • Increases pitta and kapha • Water and fire • Stimulates and improves appetite, saliva production, and digestion • Light, heating, and oily properties • Awakens thoughts and emotions • Eaten in moderation because excess leads to feelings of aggression
Salty Sea vegetables, sea salt, tamari, black olives, Himalayan salt, and Kosher salt • Decreases vata • Increases pitta and kapha • Earth and fire • Grounding and hydrating • Aggravates pitta and kapha • Seasons food • Stimulates digestion • Helps electrolyte balance
Pungent Hot peppers, ginger, onions, garlic, mustard, and hot spices • Increases vata and pitta • Decreases kapha • Fire and air • Hottest/spicy
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Chapter 6 Digestion and nutrition in ayurveda and Chinese medicine
• • • • •
Stimulates digestion, improves appetite Clears sinuses Stimulates blood circulation Heightens the senses Helps one to think quickly and clearly and understand complicated matters • Too much pungent makes one overly critical • Best combined with sour, sweet, or salty foods
Bitter Raw green vegetables, turmeric, and green, black, and most herbal teas • Increases vata • Decreases pitta and kapha • Air and ether • Coolest and lightest • Removes waste products from the body • Mental purification • Guards against passions and sultry emotions
Astringent Unripe bananas, green grapes, pomegranates, cranberries, green beans, alfalfa sprouts, and okra • Increases vata • Decreases pitta and kapha • Air and earth • Mental purification and strength
Traditional Chinese medicine Kidney Bladder
UMAMI
Lung
SWEET Upper Jiao
Heart
SALTY
© Can Stock Photo
SOU
R
BITTER Middle Jiao
SOUR
dder Gall bla Liver
Stomach Spleen
Lower Jiao
Gall bla dder Liver
68
Chapter 6 Digestion and nutrition in ayurveda and Chinese medicine
The five zang organs and their flavors Liver/sour • Tomato, orange, kiwi, and vinegar • Calms the body of emotional upset Heart/bitter • Bitter gourd, pomelo, mustard leaf, and other bitter green vegetables • Clears heat Spleen/sweet • Tonifies the body Lung/spicy • Spring onion, ginger, garlic, and pepper • Expels internal wind and cold from the body Kidney/salty • Seafood, kelp, seaweed • Dissolves stagnation
Further reading Hsu PC, Huang YC, Chiang JY, Chang HH, Liao PY, Lo LC. The association between arterial stiffness and tongue manifestations of blood stasis in patients with type 2 diabetes. BMC Complement Altern Med. 2016 Aug 27; 16(1):324. https://doi.org/10.1186/s12906-016-1308-5. PMID:27567605. Kim M, Cobbin D, Zaslawski C. Traditional Chinese medicine tongue inspection: an examination of the inter- and intrapractitioner reliability for specific tongue characteristics. J Altern Complement Med. 2008 Jun;14(5):527e536doi. https://doi.org/10.1089/acm.2007.0079. PMID:18564955. Kurande V, Bilgrau AE, Waagepetersen R, Toft E, Prasad R. Interrater reliability of diagnostic methods in traditional Indian ayurvedic medicine. Evid Based Complement Alternat Med. 2013;2013:658275. https://doi.org/10.1155/2013/ 658275. Epub 2013 Sep 26 PMID:24191170. Lee TC, Lo LC, Wu FC. Traditional Chinese medicine for metabolic syndrome via TCM pattern differentiation: tongue diagnosis for predictor. Evid Based Complement Alternat Med. 2016;2016:1971295. https://doi.org/10.1155/2016/ 1971295. Epub 2016 May 25. PMID:27313640. Sun S, Wei H, Zhu R, Pang B, Jia S, Liu G, Hua B. Biology of the tongue coating and its value in disease diagnosis. Complement Med Res. 2018;25(3):191e197. https://doi.org/10.1159/000479024. Epub 2017 Sep 29. PMID:28957816. Wu TC, Wu KL, Hu WL, Sheen JM, Lu CN, Chiang JY, Hung YC. Tongue diagnosis indices for upper gastrointestinal disorders: protocol for a crosssectional, case-controlled observational study. Medicine (Baltimore). 2018 Jan;97(2):e9607. https://doi.org/10.1097/MD.0000000000009607. PMID: 2948086. Xu ZX, Xu J, Yan JJ, Wang YQ, Guo R, Liu GP, Yan HX, Qian P, Hong YJ. Analysis of the diagnostic consistency of Chinese medicine specialists in cardiovascular disease cases and syndrome identification based on the relevant feature for each label learning method. Chin J Integr Med. 2015 Mar; 21(3):217e222. https://doi.org/10.1007/s11655-014-1822-6. Epub 2014 Jul 30. PMID:25078360.
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Chapter 6 Digestion and nutrition in ayurveda and Chinese medicine
Ye J, Cai X, Yang J, Sun X, Hu C, Xia J, Shen J, Su K, Yan H, Xu Y, Zhang Y, Zhang S, Yang L, Zhi H, Gao SP, Yu Q, Hu J, Cao P. Bacillus as a potential diagnostic marker for yellow tongue coating. Sci Rep. 2016 Aug 31;6:32496. https://doi.org/10.1038/srep32496. PMID:27578261. Ye H, Shi ZM, Chen Y, Yu J, Zhang XZ. Innovative perspectives of integrated Chinese medicine on H. pylori. Chin J Integr Med. 2018 Nov;24(11):873e880. https://doi.org/10.1007/s11655-017-2934-6. Epub 2018 Jun 8. Review. PMID: 29882207.
The digestive tract in descending order
Blausen.com staff (2014). Medical gallery of Blausen Medical 2014. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002e4436. Perspectives of Ayurveda in Integrative Cardiovascular Chinese Medicine for Patient Compliance. https://doi.org/10.1016/B978-0-12-817570-5.00006-2 Copyright © 2020 Elsevier Inc. All rights reserved.
65
66
Chapter 6 Digestion and nutrition in ayurveda and Chinese medicine
Upper gastrointestinal tract
Lower gastrointestinal tract
Mouth
Small intestine
Pharynx Esophagus Stomach Duodenum
Large intestine
Small Large intestine intestine Duodenum Cecum and appendix Jejunum Ascending colon Ileum Transverse colon Left colic flexure Descending colon Sigmoid colon Rectum Anus
Ayurvedic medicine Ayurveda Dosh - Tongue Red Medium size tengue with green coating
Pitta Vata
Narrow tongue with cracks & pale uneven brown coating
Kapha
Larger tongue with white coating
© 2019 Anika Niambi Al-Shura. Published by Elsevier Inc. All rights reserved
Six flavors or rasas: • Sweet • Sour • Salty • Bitter • Pungent • Astringent
Chapter 6 Digestion and nutrition in ayurveda and Chinese medicine
Sweet Wheat, rice, dairy, cereals, dates, pumpkins, maple syrup, and licorice root • Decreases/balances vata and pitta • Increases kapha • Water and earth • Grounding and nourishing • Promotes longevity, strength, and healthy bodily fluids and tissues • Promotes gain weight • Heavy, oily, and moist • Slow digestion
Sour Lemon, vinegars, pickled and fermented foods, tamarind, and wine • Decreases/balances vata • Increases pitta and kapha • Water and fire • Stimulates and improves appetite, saliva production, and digestion • Light, heating, and oily properties • Awakens thoughts and emotions • Eaten in moderation because excess leads to feelings of aggression
Salty Sea vegetables, sea salt, tamari, black olives, Himalayan salt, and Kosher salt • Decreases vata • Increases pitta and kapha • Earth and fire • Grounding and hydrating • Aggravates pitta and kapha • Seasons food • Stimulates digestion • Helps electrolyte balance
Pungent Hot peppers, ginger, onions, garlic, mustard, and hot spices • Increases vata and pitta • Decreases kapha • Fire and air • Hottest/spicy
67
Chapter 6 Digestion and nutrition in ayurveda and Chinese medicine
• • • • •
Stimulates digestion, improves appetite Clears sinuses Stimulates blood circulation Heightens the senses Helps one to think quickly and clearly and understand complicated matters • Too much pungent makes one overly critical • Best combined with sour, sweet, or salty foods
Bitter Raw green vegetables, turmeric, and green, black, and most herbal teas • Increases vata • Decreases pitta and kapha • Air and ether • Coolest and lightest • Removes waste products from the body • Mental purification • Guards against passions and sultry emotions
Astringent Unripe bananas, green grapes, pomegranates, cranberries, green beans, alfalfa sprouts, and okra • Increases vata • Decreases pitta and kapha • Air and earth • Mental purification and strength
Traditional Chinese medicine Kidney Bladder
UMAMI
Lung
SWEET Upper Jiao
Heart
SALTY
© Can Stock Photo
SOU
R
BITTER Middle Jiao
SOUR
dder Gall bla Liver
Stomach Spleen
Lower Jiao
Gall bla dder Liver
68
Chapter 6 Digestion and nutrition in ayurveda and Chinese medicine
The five zang organs and their flavors Liver/sour • Tomato, orange, kiwi, and vinegar • Calms the body of emotional upset Heart/bitter • Bitter gourd, pomelo, mustard leaf, and other bitter green vegetables • Clears heat Spleen/sweet • Tonifies the body Lung/spicy • Spring onion, ginger, garlic, and pepper • Expels internal wind and cold from the body Kidney/salty • Seafood, kelp, seaweed • Dissolves stagnation
Further reading Hsu PC, Huang YC, Chiang JY, Chang HH, Liao PY, Lo LC. The association between arterial stiffness and tongue manifestations of blood stasis in patients with type 2 diabetes. BMC Complement Altern Med. 2016 Aug 27; 16(1):324. https://doi.org/10.1186/s12906-016-1308-5. PMID:27567605. Kim M, Cobbin D, Zaslawski C. Traditional Chinese medicine tongue inspection: an examination of the inter- and intrapractitioner reliability for specific tongue characteristics. J Altern Complement Med. 2008 Jun;14(5):527e536doi. https://doi.org/10.1089/acm.2007.0079. PMID:18564955. Kurande V, Bilgrau AE, Waagepetersen R, Toft E, Prasad R. Interrater reliability of diagnostic methods in traditional Indian ayurvedic medicine. Evid Based Complement Alternat Med. 2013;2013:658275. https://doi.org/10.1155/2013/ 658275. Epub 2013 Sep 26 PMID:24191170. Lee TC, Lo LC, Wu FC. Traditional Chinese medicine for metabolic syndrome via TCM pattern differentiation: tongue diagnosis for predictor. Evid Based Complement Alternat Med. 2016;2016:1971295. https://doi.org/10.1155/2016/ 1971295. Epub 2016 May 25. PMID:27313640. Sun S, Wei H, Zhu R, Pang B, Jia S, Liu G, Hua B. Biology of the tongue coating and its value in disease diagnosis. Complement Med Res. 2018;25(3):191e197. https://doi.org/10.1159/000479024. Epub 2017 Sep 29. PMID:28957816. Wu TC, Wu KL, Hu WL, Sheen JM, Lu CN, Chiang JY, Hung YC. Tongue diagnosis indices for upper gastrointestinal disorders: protocol for a crosssectional, case-controlled observational study. Medicine (Baltimore). 2018 Jan;97(2):e9607. https://doi.org/10.1097/MD.0000000000009607. PMID: 2948086. Xu ZX, Xu J, Yan JJ, Wang YQ, Guo R, Liu GP, Yan HX, Qian P, Hong YJ. Analysis of the diagnostic consistency of Chinese medicine specialists in cardiovascular disease cases and syndrome identification based on the relevant feature for each label learning method. Chin J Integr Med. 2015 Mar; 21(3):217e222. https://doi.org/10.1007/s11655-014-1822-6. Epub 2014 Jul 30. PMID:25078360.
69
70
Chapter 6 Digestion and nutrition in ayurveda and Chinese medicine
Ye J, Cai X, Yang J, Sun X, Hu C, Xia J, Shen J, Su K, Yan H, Xu Y, Zhang Y, Zhang S, Yang L, Zhi H, Gao SP, Yu Q, Hu J, Cao P. Bacillus as a potential diagnostic marker for yellow tongue coating. Sci Rep. 2016 Aug 31;6:32496. https://doi.org/10.1038/srep32496. PMID:27578261. Ye H, Shi ZM, Chen Y, Yu J, Zhang XZ. Innovative perspectives of integrated Chinese medicine on H. pylori. Chin J Integr Med. 2018 Nov;24(11):873e880. https://doi.org/10.1007/s11655-017-2934-6. Epub 2018 Jun 8. Review. PMID: 29882207.