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Today, we are going to talk about something that is part of your everyday life since you were born. This something is capable of bringing you relief, frustration and might even make you break out in a sweat. That something is your p**p! Lots of information about the gastrointestinal system and overall body health can be garnered from your stools. However, it is often difficult to determine what the different types of appearances actually mean. Therefore, in this episode, we are going to talk about your stools and what it symbolizes from the TCM perspective, as well as some tips on rectifying the abnormality and maintaining healthy bowel movements.

Before talking about what’s abnormal, we shall address what appearance normal healthy stools should have. Descriptively, normal healthy stools should be light to dark brown in colour, the shape would be like a log or sausage that is soft but firm, the smell partially depends on the food ingested, but should not be too pungent, bowel movements should be smooth, painless and with ease, the frequency can vary from every other day to 3 times a day, and each time the duration should not last for more than 15 minutes.

As for what abnormal stools look like, we will be using the bristol stool chart for reference. Starting off with signs of constipation, it has two common types of appearance. The first is presented as small, hard and lumpy pellets that are extremely difficult to pass out, often causing great pain and discomfort. The second type is presented as a sausage-like shape but lumpy. The size of these stools can get pretty huge if it is left in the colon for an extended period of time. Such cases are often accompanied by the desire to p**p but often find it difficult to do so and require considerable straining.

TCM perceived these two types of constipation as two different forms. The first type of constipation usually corresponds to a depletion of fluids to the extent of causing blood, and subsequently, the Yin part of the body to be exhausted. Possible causes for the fluid loss include exogenous heat factors, improper and unbalanced food diets, and emotional instability like anger and frustration. These factors are capable of allowing flare to accumulate within the body, depleting the fluids, blood and Yin, resulting in the hard stools. So, simple tips in helping to clear away the flare within the body include dispelling the heat factors, drinking more water, integrating more fruits and vegetables in your diets, making a habit of p**ping regularly and not suppressing the urges, and lastly keeping your emotions in check.

The second type of constipation is usually perceived as a stagnation of Chee, or a deficiency of Chee to the extent of affecting the body’s Yang Chee. Chee is important within the body. In this case, it not only motivates bowel movements but also involves regulating the normal functions of the organs, allowing metabolization of fluids and blood for nourishment. Emotional instability, like depression and anxiety, disrupts the Chee movements, while fatigue and improper diets that hurt the spleen, like ingesting too many cold items on a daily basis, are capable of depleting Chee. So, simple tips include regulating diets to avoid cold and raw food and drinks, and integrate more black fungus and black sesame seeds, keeping your emotions in check through regular exercise, yoga, and stress management techniques, and lastly, work-life balance to avoid fatigue.

Moving on, the next signs of abnormal stools correspond to different degrees of diarrhoea. The first is presented as small and soft pieces of stools. These stools still have a definite shape and are usually very easy to pass out. The second type is presented as a mushy muddy semi-solid state with no clearly defined shape. The third type is completely in a watery state, in other words, pure diarrhoea.

TCM perceived diarrhoea as a dysfunction of the digestive system, along with dampness that had accumulated internally as the general pathogenesis. The main organ to note is the spleen as it is the main organ involved in the transformation of food, water, and dampness. In a weakened state, a spleen with Chee deficiency would correspond to the first type of stools seen for diarrhoea, along with remnants of undigested food in your stools, signs of bloatedness, loss of appetite, and bowel movements could even be triggered by greasy food. However, if the symptoms described above were absent, these small pieces of soft stools can actually be seen in normal healthy people that p**p 2 or 3 times a day. So, simple tips on improving the spleen include integrating more coarse gains in your diets, chewing your food thoroughly, regular exercise and avoiding excessive fatigue.

The mushy muddy stools could be signs of a hypersensitive, or hyperactive colon. Abdominal pains often accompany such bowel movements with heightened sense of urgency. These movements are usually induced by stress or taking too much spices that irritate the gastrointestinal tract. TCM perceives stress and other emotional instability, like anxiety and anger, as a dysfunction of the Chee mechanism. This dysfunction not only caused the stomach pain, the diarrhoea that follows and the mushy stools, but also induced bloatedness, belching and distension pains to the sides. In such cases, keeping your emotions in check plays a huge part. Some simple tips would include various stress management and relaxation techniques through regular exercise, yoga, mediation, and deep breathing exercises.

On the other hand, ingesting too many spices or spicy food would lead to an accumulation of heat-dampness within the digestive system. In this case, the spices would induce an acute abdominal pain, heightened sense of urgency to use the toilet, followed by burning sensations at the opening of the a**s, coupled with an unclean feeling at the end. As such, simple tips include avoid ingesting too many spicy foods that will trigger the diarrhoea, and consuming dairy products while having the spicy food can help neutralize the diarrhoea effect. After the diarrhoea, it is also advisable to hydrate to replenish the fluid loss.

The last watery state of the stools is perceived as two forms from the TCM perspective. The first being the clear watery state as opposed to the muddy watery state of the second type. The clear watery type of stools is perceived by TCM to be caused by cold exogenous factors. These factors are capable of disrupting the spleen’s Yang Chee, resulting in dampness to accumulate and causing the diarrhoea. Flu-like symptoms like fever, headache, nasal congestions, body pains and aches can also be associated with such diarrhoea. As such, simple tips include dispelling the exogenous cold factor from your body, keeping your body warm, like having some warm porridge can help in warming up the body as well as replenishing the fluids loss, eating food that is easy to digest would help in lessening the burden on the digestive system while it recovers, and lastly, consult a physician if the symptoms are severe.

Conversely, the muddy watery state of diarrhoea is said to be due to improper binge eating, food contaminations, infections and food intolerances. These factors are able to harm the digestive system, causing dysfunction and resulting in the diarrhoea. The stools are usually very pungent, and coupled with signs of abdominal distension, abdominal pains, and stomach rumblings. The pain and distension tend to subside after the diarrhoea. Therefore, in cases of food contaminations and food intolerances, TCM emphasizes on expunging the contaminant from the body through carefully induced vomiting and diarrhoea. It is also important to replenish the lost fluids by taking sips of warm water to prevent dehydration. Eating easy to digest food would help in the recovery. Lastly, if the symptoms are severe or persistent diarrhoea occurs, it is best to consult a physician for a more thorough treatment.

That’s all for today. So the next time you p**p, don’t be so hasty to flush, pinch your nose and take a look. Tune in next time for the second part where we talk about the colour of your stools.

Today is the last of the 5 organs in TCM series and it is the kidneys. 所谓：“肾者作强之官，伎巧出焉”. There are many interpretations for this saying but there’s no denying that the kidneys in TCM play an important role in our body. From birth to growth to ageing to procreation to metabolism to immunity, the kidneys are involved in all of it. Again, I have to emphasize that this is a comprehensive integrated functioning unit in your body from the TCM perspective as opposed to the anatomical kidneys involved in the renal system.

So, the first primary function is that the kidneys store the essence of the entire body. We say that “肾者主蛰,封藏之本,精之处也”. Figuratively, you can imagine that the essence is the vast fortune that you keep in the vault, and the kidneys are the gates or keys to the vault. So, you might ask what exactly is this essence? And why is it so important that you have to keep it ‘locked up’? In TCM, the essence stored within the kidneys is basically the source of human life. From this essence, it transforms into primordial Chee or 元气 that is involved in maintaining life by being the invigorator behind all life activities. Besides maintaining life and transforming into primordial Chee, the essence is also able to nourish every part of the body indirectly by first enriching every organ. Since the essence is stored within the kidneys, it is said that the kidneys have the ability to influence every part of your life. Examples include the innate endowments of your body from birth, determining the rate of growth and development, and even the ups and downs of every organ’s functionality. Hence the kidneys in TCM is highly revered and seen as the origin of congenital constitution termed as “肾为先天之本”.

Other than storing essence, the kidneys also play an important role in water metabolism of the body as part of being a “水脏“. In terms of water metabolism, the kidneys are basically involved in every part of the process from absorption to transformation to excretion. This is achieved through the ability of the kidney’s Chee transformation that motivates every organ involved in water metabolism from behind the scenes. So, what it means is that in the presence of a strong kidney Chee, the organs would also have ample Chee and thus be able to function normally. If there is a deficiency in the kidney’s Chee then dysfunction of the organs would easily occur and water would not be able to be metabolised properly, resulting in fluid retention related complications.

The last of the kidney’s function involves respiration which is termed as ‘肾主纳气’. Although breathing is accomplished mainly by the lungs, TCM strongly believes regulated inhalation and exhalation ties deeply to the kidneys. It is believed that after the lungs had inhaled fresh air, the air must be able to reach down and be received by the kidneys. This action is a coordinated effort by both organs. Only when the air is received by the kidneys can the breathing be stable and deep. This then ensures the proper exchange of air within the body. If the kidneys are compromised, which causes dysfunction in this area of respiration, it can be presented clinically as shallow breathing, shortness of breath, and even asthmatic condition when exerted physically.

So in summary, the kidneys are revered highly in TCM. It primarily stores the essence of the body within itself and thus is able to influence the body in every aspect from birth to death to procreation to immunity. Basically, it is the source of life. Other than storing essence, it is also involved largely in the metabolism of water and air. So, one must take good care of the kidneys, maintain the source of life and live longer and healthier.
That’s all for the kidneys as well as the 5 organs in TCM series. Tune in next time for more TCM related topics!!

Today we will touch on the liver, 肝者，将军之官，谋虑出焉。In literal translation, it means that the liver is like the general of your body, and like the general, it is the organ that is in charge of strategic formulations and decision making. You might say that ‘hey, isn’t that part of the thought process? Isn’t that done by the brain?’ Although it is true that the brain, or in TCM perspective the heart and the brain, governs all conscious thought and logic overall, the liver in TCM is making the strategic formulations and decision making subconsciously and instinctively. One such example is the fight-or-flight response.

Looking from another aspect, the liver in TCM governs the emotional entity of human psychology. In TCM the seven universal emotions include joy, anger, worry, sadness, fear, surprise, and cognition. All this is regulated through the primary function of the liver, which is ‘肝主疏泄‘。This means that the liver in TCM has the ability to regulate the Chee mechanism in the whole body, allowing Chee to flow smoothly without hindrance. But what has Chee got to do with emotions? So if you don’t already know, the 5 organs in TCM corresponds to its own emotion. As such a normal healthy emotional activity relies heavily on the vital essence of the organs as well as the fluidity of Chee and blood that runs through these organs. The liver, which regulates the entire body’s Chee mechanism, invigorates and manages the whole body’s Chee and blood. As such the liver can directly affect the emotional activity. Other than the psychological aspect, stagnation in the Chee mechanism can also affect the body physically in many ways. Some examples include blood stasis, fluid retention, and can even affect menstrual cycles for the ladies.

The second function of the liver is ‘肝主藏血’. This means that the liver has the ability to store and regulate the amount of blood in the body. If the body requires more blood while doing activities, the liver would release the blood into circulation. Conversely, when the body is inactive, for example during resting at night, the excess blood flows back into the liver for storage. This function can be illustrated in terms of the menstrual cycle for our ladies too. A healthy functioning liver would be able to release sufficient blood into the uterus and that would allow normal periodic menstruation to occur. Hence this saying “肝养血，女子以血为本，以肝为先天“, which suggests that the ladies are highly reliant on the liver’s health. If dysfunction were to occur in this aspect, it can be presented as haemorrhage. Ladies might see an abnormally excessive amount of menstrual blood during their period.

Besides storing blood, the liver in TCM is said to be in charge of the entire body’s ligaments and tendons, known as ‘肝主身之筋膜‘。 The reason being is that the nourishment of these ligaments and tendons is dependent on the liver’s blood. If malnourishment were to occur, it can be presented in two forms. One is flaccid paralysis or motor impairment; the second is in the form of spasms, termed as “肝风内动” in TCM.

So, in summary, the liver in TCM primarily governs dispersion of the Chee mechanism as well as stores blood for the body. Although these two functions are a separate entity, they actually complement each other and keep each other in check. Example, due to the dispersion of the liver’s Chee, the Chee mechanism is able to flow smoothly and this, in turn, helps to ensure the smooth flow of the blood, allowing blood to be stored in the liver. With ample blood in the liver, it is able to keep the Chee dispersion of the liver in check, preventing overdispersion.
That's all for today, tune in next time for the last topic of the 5 organs in TCM series, the kidneys.

Today we are going to touch on the spleen. In TCM, we say that ‘脾胃者，仓廪(lǐn)之官，五味出焉’. It means that the spleen works in tandem with the stomach in the digestion process, allowing food to be broken down for absorption. Again I have to emphasize that this is a comprehensive integrated functioning unit in your body from the TCM perspective, as opposed to the anatomical spleen that is involved in the lymphatic system we see in medical records.

So let us first go through the digestion process. Food is broken down in many layers within our body. After being chewed into smaller pieces by the mouth, the food enters our stomach where it gets broken down. After that, it leaves the stomach and enters the small intestine. The small intestine then further digests the food and differentiates the food essence for absorption. The remnants go into our large intestine to be excreted.

So, you may ask, where’s the spleen in all of this? Although digestion of the food is accomplished mainly by the stomach and the small intestine superficially, the spleen, or more specifically the spleen’s Chee, is actually involved in the whole process by being the invigorator behind these two organs. After the stomach has primarily broken down the food, the spleen’s Chee aids in further digestion before entering the small intestine. In the small intestine, the spleen’s Chee aids in differentiating and absorbing of the food essence, transforming it into nourishment for the body, which includes Chee, blood, and fluids. After that, the spleen’s Chee distributes the nourishment throughout the whole body with help from the lungs and the heart. This whole function is termed as ‘脾主运化‘ in TCM. If this functionality of the spleen’s Chee is compromised, then digestion and absorption of the food essence would be affected and this can be presented as indigestion, bloatedness, loss of appetite, lethargy, and even malnourishment in severe cases.

Besides food, this functionality ‘脾主运化‘ also involves water and its distribution. Similar to how food is been transformed, water is also transformed into viable fluids to be distributed throughout the body for nourishment through the same process. As for water distribution, the spleen, being situated in the middle of the body, plays an important role by being the mediator throughout the upwards and downwards distribution of water within the body. It is said that a strong healthy Chee of the spleen will ensure normal water metabolism, thus preventing any abnormal water stagnation within the body that would result in dampness, phlegm, and fluid retention. Hence this saying from 素问： ‘诸湿肿满，皆属于脾’.

The second function of the spleen is what we call ‘脾主统血‘. This means that the spleen’s Chee is capable of regulating and maintaining the blood within the vessels, which prevents haemorrhage from occurring. This function, however, ties strongly with the first primary one mentioned earlier. Why you might ask? The reason is that although Chee is the main governing body for blood, it is not inexhaustible, and the source of Chee is highly dependent on the first functionality of the spleen which emphasizes on the production of Chee blood and fluids. A deficiency in Chee would be presented as haemorrhage beneath the skin, in your urine or stool, and even in cases of excessive menstrual blood.

That is all for the spleen’s functionality. So, in summary, the spleen’s first and foremost function is aiding in digestion, and involved in the transformation and distribution of both the essences of food and water. This transformation ultimately becomes nourishment for the whole body. We call this ‘脾主运化’. This functionality also allows the spleen to act as the mediator for water distribution. The second function is that the spleen aids in securing blood within its vessels. We call this ‘脾主统血’. However, this is heavily dependent on the first function as the source. So keep your spleen healthy would let you have an endless source of nourishment for the body.

In the previous episode, we talked about the lungs and how it acts as a regulatory role in the body. Today, we are going to talk about the heart and it begins with this saying “心者,君主之官,神明出焉”. In literal translation, it means that the heart is the most important organ in your body, and it is where ‘神‘ is exhibited. Again, it should be noted that the heart in this TCM context is not the literal anatomical heart, but rather a comprehensive integrated functioning unit in your body.

So why do we say that the heart is the most important organ in your body? The reasons tie heavily to its function. First and foremost, we say that “心主血脉”。it means that the heart governs the blood and the blood vessels. Through the heart’s Chee, it is able to push and promote blood flow throughout the entire body, nourishing every organ, every bone, every muscle, basically every part of your body. Without any nourishment from the blood, the system is compromised. Hence, the importance of blood and its governing organ, the heart.

The second reason is a bit complicated and it encompasses the idea of ‘神’。so what is “神”？ the concept of ‘神‘ is enigmatic and it is said to be the basis of everything and involved in every change. Within the human body, it is said to be the basis of human life and governs all life activities. Examples of life activities can be presented in cellular level forms like metabolism and excitability (adaptability, reproduction). The secondary illustration of ‘神’ would include your consciousness, thoughts, emotions, and behavioural patterns. You may think that ‘hey, isn’t that brain activity? What has it got to do with the heart?’ This question has always been a controversy since ancient times. There are discrepancies whether the brain or the heart governs ‘神’. Based on modern studies, the brain is largely involved in the nervous systems and handles basically everything that the body does. As such there are sayings of ‘脑主元神‘. So what about the heart? And is there any relation between them? The answer ties heavily to its primary function which is mentioned earlier, ‘心主血脉’. Blood is said to nourish every part of the body and that includes the brain. It can be said that blood is the fundamental sustenance for ‘神‘. Therefore, the heart, which governs blood and its vessels, is able to reflect the conditions of ‘神’。 hence the saying, ‘心者，神之舍也‘ or ‘心主藏神’.

Some examples that illustrate their relationship: in cases where the heart is healthy with ample chee and blood, you would feel energetic, your mind would be alert, and armed with critical thinking. Conversely, with a deficiency in the heart’s chee and blood, lethargy will set in, fumbling in speaking, your memory would be affected, and could even cause anxiety in severe cases.

So, thats all for today, maintaining a strong heart would keep your mind and body healthy and strong. Tune in next time for the next topic the spleen.

The 5 major organs consist of lungs, heart, liver, spleen, kidneys
Each has its own role to play in the body.
The lungs play a regulatory role in the body. In TCM we call, ‘肺者，相傅之官，治节出焉‘. It relies heavily on its Chee to achieve its role, which has the ability to disperse and descend, which is called ‘肺主宣发肃降’

Involved in the exchange of air from the environment 肺主呼吸之气:
Through the descending ability, fresh oxygenated air is inhaled into the lungs. Likewise, through dispersion, the expulsion of air is then possible. A harmonising of these two abilities would lead to regular normal breathing. If there’s any dysfunction in any of them, it’s usually presented as a breathing issue (eg. asthmatic, coughing, shortness of breath, etc.)
As such, it is said that the lungs govern the entirety of Chee within the body, known as 肺主一身之气. There are two reasons why, firstly, the dispersing and descending of the lungs’ Chee is the basis of how the Chee mechanism in the body works, which involves up and down, in and out. Therefore. it is said that the lungs play an important part in regulating the entire body’s Chee movements. Secondly, the air that the lungs take in constitutes the formation of 宗气, which combines with 元气 to become the body’s Chee or 一身之气. It is important as this Chee is the main motivator behind the entire body’s psychological activity, maintaining life. A drop in the lung's functionality would directly impact the formation of 宗气, which then affects the entirety of the body’s Chee.

Other than breathing, the lungs also regulate water distribution throughout the entire body known as, 肺主行水. After the spleen’s Chee sends up the essence of food and water, the lungs distribute it upwards and outwards through dispersion; downwards and inwards through descension, nourishing the entire body. The fluids after being metabolised turn into wastewater and is channeled downwards by the lungs’ Chee to the kidneys and bladder in the form of urine.

Involved in blood circulation as an assistive role. The heart is the primary motivator behind the blood circulation. The lungs chee assist the blood flow through regulating and maintaining proper chee channels within the body, promoting circulation.

Today, we are going to touch on something that I am guessing is highly relatable to a lot of people living here in Singapore, and that is dampness. So, what is dampness? How does it affect our body and system? And lastly, how can we regulate and keep it under wraps? These are the questions we will address in this episode.

Dampness is just as the name suggests, it is water. But it is water that has become a pathological complication within our body. The general clinical term in TCM is called ‘湿气‘ or ‘湿邪’ and it can be categorized into external and internal dampness, called ‘外湿‘ and ‘内湿’. The source of external dampness comes from our environment. From the humidity in the air, to the water that comes in contact with our skin, to even our sweaty clothes that cling to our body. Basically it is all forms of dampness that comes into contact with our body. Internal dampness arises mainly from a dysfunction of the spleen. Why? Because the spleen not only is the main organ in charge of metabolising and transforming water into viable fluids, it is also involved largely in water distribution. A dysfunction would allow dampness to accumulate and if not expunge, it would cause many complications to the body.

Why is dampness such a fearsome foe? There is even a saying “千寒易除，一湿难去” which illustrates the difficulty in getting rid of this nuisance that is dampness in our body. To find out the reason, we have to look at the nature and properties of dampness. In TCM, dampness has the following characteristics: it is heavy and turbid, in terms of Yin and Yang categorization, it belongs to the Yin category, it is sticky in nature, it is able to permeate the body easily, causing complications in every part of our body, from our skin and muscle externally to our organs internally. Furthermore, it likes to combine with other pathogenic factors to wreak havoc in our body. Examples would be like cold-dampness, heat-dampness and wind-dampness or rheumatism. So what do all these characteristics mean?

As part of its Yin characteristics, once it invades the body, our body’s opposing Yang Chee would rise up to combat the dampness. As such, it is said that dampness is able to hurt and deplete our Yang Chee. In the case of our spleen, a disruption in the spleen’s Yang Chee will affect its normal functionality, giving rise to even more internal dampness as mentioned earlier. If left to accumulate, severe complications like prolonged diarrhoea due to hypofunction of the spleen, water retention, and even oedema can appear.

The nature of it being sticky and viscous is largely the reason why it is so difficult to get rid of it. This stickiness and viscosity are said to be able to disrupt the Chee mechanism easily, causing hindrance to the flow of Chee within our body. Although this hindrance is less severe as compared to the depletion of Yang Chee mentioned earlier, it can still affect the normal functionality of our organs, particularly our spleen and stomach. Some clinical examples would be bloatedness, loss of appetite, nausea, and distending pain. This disruption of the Chee mechanism would also cause more dampness to accumulate, leading to an endless vicious cycle. Without proper treatment, the dampness would persist in your body, prolong the clinical course of the ailment and a recurrence of the ailment could even occur.

So, how do we tell that dampness has already invaded our body? Besides some of the clinical presentations described earlier, dampness can also be presented in simpler ways that you yourself can take note of first thing in the morning. Firstly, the moment when you wake up, if you feel that your head is muddled as though there is some invisible thing wrapped around your head and body, causing you to feel lethargic, and you just don’t want to get out of bed, it’s indicative of dampness within your body. Secondly, when you are brushing your teeth, if you feel disgusted with puking sensations, especially when coupled with lots of phlegm and a grimy feeling at the back of your throat, it’s indicative of dampness. Thirdly, after you are done brushing your teeth, take a look at your own tongue. If the coating on the tongue is thick, grimy and you just feel unclean, then it’s indicative of dampness. Lastly, look at your own bowel movements and stools. Normal bowel movements would be smooth and unobstructed, the stools would feel neither too hard nor too soft when passing out, and normal stool appearance would have a shape like a banana. If dampness strikes, then diarrhoea would occur with watery or shapeless stools. In cases where there is no diarrhoea and your stool has a definitive shape, but it is sticky and sticks to your toilet bowl or presented as staining of the bowl when flushing, or even the unclean feeling you have that requires many pieces of toilet paper to properly wipe clean, those are all indicative of dampness.

So lastly, here are some simple tips you can use to rid yourself of dampness: firstly, exercise is important. Regular exercise is able to invigorate the Yang Chee in the body and dispel the dampness through sweating. Secondly, have a positive outlook in life and find healthy ways to help you destress. This would help in ensuring that your Chee mechanism flows smoothly in your body, preventing dampness to accumulate. Thirdly, take note of your diet. Avoid eating too much cold and raw food, hard to digest tough meats, and too much spicy food. These foods would put too much burden on your spleen. Over taxation of your spleen would lead to a hypofunction, allowing dampness to accumulate. In the case of spicy foods, a slight amount can help in epidermal circulation and that opens up the pores and induces sweating. However, too much spicy food would let heat-dampness to accumulate internally if the spleen is not able to process them. So, do take note. Periodically, you can consume food that can help in improving your spleen’s function and rid of dampness within the body. Some examples would be like Chinese barley, red bean, winter melon, Chinese yam, and lotus seed.

Do take care and let us all do our very best in our fight against dampness. Stopping and curbing it at its source before it accumulates is the key. That’s all for today, tune in next time for more TCM related topics.