The Dao of Longevity - Seasonal Harmonization for Autumn
Dr. Henry McCann
In the Lü Shi Chun Qiu (The Spring and Autumn Annals of Lü Bowei; 呂氏春秋), the classic text of Chinese philosophy from the 3rd century BCE, it is said that the Emperor Shao Hao (少昊), and his son Ru Shou (蓐收) are the sovereigns associated with the three months of Autumn. This obscure statement sheds tremendous light on the essence of Autumn, and eventually allows us to understand how to stay healthy this season.
According to some legends (since they do vary), Shao Hao was one of the Five Emperors (五帝) of ancient China (Figure 1). His mother was a weaver goddess who fell in love with the planet Venus, and the result of that union was Shao Hao. Together with his son Ru Shou, Shao Hao settled on Chang Liu Mountain where they ruled over the Western Heavens and controlled the setting of the sun. In Chinese sciences the west is associated with the Metal phase, and therefore Autumn. Certainly, Autumn is the time of year that corresponds to sunset during the day, and in traditional Chinese astrology Venus is the planet of the Metal phase, and thus too corresponds with Autumn. Even the son’s name, Ru Shou, has the word “shou” (收) within – the word meaning “to harvest” or “to collect,” an attribute of Autumn. In previous issues we have explored Spring and Summer, so now it is now time to turn our attention to the time of the year that is the setting of the sun so to speak – Autumn.
Yin, Yang and the Five Phases of Autumn
In our previous articles we introduced one of the most important natural theories of Chinese science: Yin-Yang Theory (Yin Yang Li Lun 陰陽理論). The terms Yin (陰) and Yang (陽) each originally referred to the shady and sunny sides of a hill respectively, and describe pairs of complementary opposites. For example, in the body this can be seen as the pairs of inside and outside, front and back, organs that store or move, and blood and qi. In the natural world Yin and Yang relate to cold and hot, or night and day.
Spring and Summer, the previous two seasons, are Yang seasons. Why is this? During Spring all of nature begins to wake from its cold Winter’s slumber. Plants germinate and trees leaf out. Over time everything that was in a state of being frozen starts to shake off its icy mantle and stir to new life. All of these activities are the definition of Yang. We also call Spring the time of “Lesser Yang” (shao yang 少陽), since Spring is the time of Yang’s birth. When Summer arrives all of life is in its fullest growth potential. Plants are blooming and bearing fruit, the days are the long, and the heat is the highest of the year. This culmination of growth marks Summer as the “Greater Yang” (tai yang 太陽).
One of the basic laws of Yin and Yang is called the rule of mutual transformation, or mutual conversion (yin yang zhuan hua 陰陽轉化). This law describes that when either Yin or Yang reaches its zenith, it spontaneously transforms into its opposite. For example, in the dark hours around midnight Yin is at its greatest point during the day. At that moment Yang is born, starting to take over and grow. During the course of the year, the Summer Solstice (xia zhi 夏至) marks the apex of Yang. After that, all the earth begins the slow transition to Yin, the transition to cold and Winter. Therefore, Fall is the first season that is designated Yin. But, since it is just the beginning of Yin movement in the natural world and not its culmination, we designate Fall the “Lesser Yin” (shao yin 少陰).
In Five Phase Theory (五行理論) this Lesser Yin movement is called “Metal.” Recall from our previous articles the famous eight-character phrase from the Huang Di Nei Jing (also known as the Nei Jing for short), the ancient core text of medicine in China: “Spring gives birth, Summer grows, Autumn harvests and Winter stores.” (春生, 夏長, 秋收, 冬藏) The Metal phase is summarized by that one word associated with Autumn – “harvest.” Autumn is the season when everything is in a state of inward contraction. Plants start to die or to hibernate, and the weather becomes cooler and drier. In addition to the Autumn season, Metal is associated with the setting of the sun each day and the Venus planet in the heavens (as we discussed above with the legend of Shao Hao). Metal represents dryness and the color white. In the body Metal is the Lung among the Zang-viscera, and the Large Intestine among the Fu-bowels. By extension from these internal organs, Metal represents the skin and hair, the nose (i.e., both the upper and lower respiratory tract) and the sense of smell. The taste of Metal is acrid (spicy), its associated grain is rice, and the domestic animal is the horse (see Table 1). The Confucian tradition speaks of the Five Constant Virtues (五常), and the virtue associated with Metal is selflessness – Yi (義). Also in the Confucian tradition, the mental poison of the Metal phase is criticism or judgment – Nao (惱).
The Nei Jing on Autumn
The second chapter of the Su Wen section of the Nei Jing is titled The Great Treatise on Regulating the Spirit with the Four Seasons (四氣調神大論). This chapter gives basic descriptions of the four seasons and, based on Yin-Yang and Five Phases theories, how we harmonize ourselves with each. One of the initial recommendations the Nei Jing gives us is, “In Autumn it is desirable to sleep early and get up early at the crowing of the cock.” In Summer, when everything is in a state of Yang expansion, we can stay up late and get up early without harming Qi. In Autumn however, since we are in a state of contraction, of moving towards quiescence, we should get to bed a little earlier so as to harmonize ourselves with the growing Yin influences in nature. That said, the season is still not characterized by the complete stillness of Winter, so we can get up early to get to work. Certainly, in a traditional society it was important to get up early so that crops could be harvested and stored in preparation for Winter.
The Nei Jing continues its recommendations by saying, “Let the mind-will be peaceful and tranquil, so as to temper the punishment carried out in Autumn. Collect the Shen [Spirit] Qi and cause the Autumn Qi to be balanced. Do not direct your mind-will to the outside so the Lung Qi remains clear.” This is an interesting statement! The recommendation about sleep is teaching us how to harmonize our physical body with the season. It means that not only should we literally get more sleep, but we should also not exert as much as in Summer if possible. In this second section the Nei Jing teaches us that body and mind are inseparable. Just as we harmonize our body with the season, we harmonize our Shen-spirit (shen 神) with Autumn as well.
When the Nei Jing talks about the “punishment” of Autumn, it means the aspect of the season that is associated with the gradual dwindling of the light, the beginning of the death phase that Autumn represents. According to the Lü Shi Chun Qiu mentioned in the beginning of this article, in ancient China Autumn was the season to carry out executions – a rather grisly practice albeit appropriate to the Metal phase season. According to the Nei Jing commentator Wang Bing, if we keep a peaceful mind state, we can minimize the killing effects of Autumn on our bodies. After all, we want to survive into Winter and then the next Spring!
Again, according to Wang Bing, “When the Shen [spirit] Qi is in turmoil, it may become too vigorous, which may cause harm to peaceful Qi; once peaceful Qi is lost, Autumn Qi may be disturbed. Thus it is important to constrict the Shen [spirit] Qi so that Autumn Qi may remain peaceful.” In general the movement of Metal and Autumn is an inward movement towards quiet. We harmonize our Spirit-mind with Autumn by engaging in quiet self reflection, an idea we revisit later in this article. In the Treatise on Heavenly Truth from High Antiquity (上古天真論 Su Wen Chapter 1) it also says, “Quiet peacefulness and absolute emptiness and the true Qi follows. When the physical form [jing] and the Shen [spirit] are guarded internally, whence could a disease come? (恬惔虛无，真氣從之，精神內守，病安從來)”
Environmental Changes of Autumn and Basic Health Recommendations
Chinese medicine associates with weather pattern of dryness (zao 燥) with Autumn. While Summer can be damp, in most of the United States Autumn is the time of diminishing rainfall and therefore diminished environmental moisture. In addition, the average temperature is dropping so the disease evil of cold (han 寒), while not yet the most prevalent, is beginning to increase it’s affect on our health. In terms of the body, the Lung and body surfaces (i.e., the skin and hair) are associated with Metal and Autumn. This time of year the Lung’s and body surface’s fluids can be damaged, as they are easily affected by environmental dryness and cold.
Autumn is the beginning of cold and flu season. These upper respiratory tract infections are some of the most common illnesses that people regularly contract and are caused by several different virus that inflame mucous membranes of the nose, throat and Lungs. One of the reasons colds are more prevalent starting in Autumn is that people spend more time indoors around others. Since the weather is cold, we are less likely to have open windows, so viruses are more easily passed between people. Aside from that, many cold and flu viruses thrive in dryer conditions, such as dryer mucous membranes in the sinuses. As Autumn is the season of dryness, it is no surprise that cold and flu season usually starts then.
One of the basic methods of staying healthy then in Autumn is to gently moisten the Lungs and the body surface, including the mucous membranes of the sinuses and throat. This can be accomplished through simple diet modifications as well as using herbal teas. Another important way to stay healthy during cold and flu season is to be sure to wash hands frequently. Better than any drug or supplement, hand washing is one of the single greatest deterrents to the spread of disease.
In Chinese medicine the Lung is paired with the Large Intestine. Some common symptoms of Autumn dryness we see are, for example, dry lips, dry skin, allergic symptoms like dry and itchy eyes, and low grade dry coughs. Dryness also impairs moisture of the intestines and can lead to constipation. While constipation in and of itself is a common condition and most people don’t take it very seriously, it can lead to many other problems down the line. Chinese medicine has the concept of the “Three Openings (san tong 三通),” three things that have to be kept open and moving for good health. These Three Openings are keeping the mind open (通腦), keeping the bowels and urine open (通小便，通大便), and keeping the channels and vessels open (通經脈，通血脈). Long-term constipation can lead to anal fissure, hemorrhoids, organ prolapse, colon cancer, and possible cardiovascular disease (Leung, et.al. 2011; Salmoirago-Blotcher, et.al. 2011).
Foods for The Season
Based on the above, the main group of foods to emphasize in Autumn is foods that moisten and nourish body fluids. These include rice, sesame seeds, honey, walnuts, spinach, apples, pears, persimmons, and grapes. Appropriate animal foods are milk products, eggs, pork, clam, crab, oyster, and mussels. Beverages that have a moistening effect include boiled water or light teas, soymilk, fruit juices, and cow’s milk. Notice here of course the addition of milk and milk products in these lists. In the west today milk has gotten a bad rap, and there are many in the natural health community suggesting it should be avoided altogether. According to Chinese medicine there is no such thing as a food that everyone should avoid, but only foods that are inappropriate to, for example, the season or our personal health status. Certainly, people who are prone to build up of phlegm and dampness should avoid milk, but, as milk is moistening, people with dryness can drink some with good health effects.
One of the flavors to emphasize in Autumn is sour. The sour flavor has an astringing function and as such helps protect and engender fluids. Sour foods include sauerkraut, sourdough breads, pickles, ume-boshi (salted plums), olives, vinegar, yoghurt, lemons, adzuki beans, cheeses, and green apples. Sour is a strong flavor so the basic recommendation is that a little goes a long way. People already prone to damp accumulation should still minimize sour foods, but people who are dry or people in average to good health can increase sour consumption this season.
People who tend to constipation, as mentioned above, need to keep things moving. One traditional recommendation for helping constipation is adequately chewing food so that it mixes well with saliva before being swallowed. Indeed, slowing down how we eat also helps bring calm, and centers us while eating (the appropriate emotional posture of the season). Increasing seeds and nuts in the diet, such as flax seeds, or sesame seeds, helps moisten and move stools. People with ongoing constipation can consider taking psyllium husk each morning.
In the Summer we recommended preparing foods using relatively light and quick methods that mimicked the light and fast moving Yang nature of Summer. As we move into the Yin-contracting time of the year, it is appropriate to use more time consuming cooking methods. Foods should be prepared over lower heat but for longer cooking times; this includes methods such as braising and cooking in crock-pots or slow cookers. These methods do two things. First, they protect the moisture of the foods being cooked. For example, roasting in an oven is too drying a method for Autumn. Second, slow cooking brings are attention into a longer process of cooking thereby slowing down our mind and our pace of life.
One particularly important dish for Autumn is congee. Congee (known as zhou in Mandarin or jook in Cantonese; 粥) is a type of porridge made with rice and has a similar consistency to runny oatmeal. The basic method of preparing congee is to boil plain rice of just about any sort in water at about a 1 to 8-10 ratio (i.e., for 1 cup of rice use 8 to 10 cups of water). The rice should be cooked for at least 30 to 45 minutes, until the rice starts breaking apart and the entire mixture has a smooth milky-white appearance. All sorts of herbs, foods, or condiments can be added into this base porridge depending on the taste preferences or health status of the person eating it. Even by itself congee is both moistening and warming, an appropriate combination for dry and cold weather.
One congee that is appropriate in Autumn is plain rice congee with lily bulb. Lily bulb is a Chinese herb that has the ability to moisten and nourish the Lung’s Yin. It can treat shortness of breath, dry cough, and sore throat with coughing. It also has a calming effect on the Heart-Shen and can be used for insomnia, agitation or restlessness. Other ingredients to add in Autumn congees include pork, leeks, fresh ginger, sesame seeds, or pine nuts.
Herbs and Teas for Autumn
There are many simple herbal teas that promote wellness this season. Since Autumn is one peak time for seasonal allergies, one strategy to employ is choosing herbal teas is to use simple single herbs to clear wind and heat from the head. Two examples of this are chrysanthemum (ju hua 菊花) and mint (bo he 薄荷). To make these teas, take about a teaspoon of either of these two herbs in their dry form (or use both!) and add to one cup of boiling hot water. Let steep and sip throughout the day. If dryness symptoms are present, such as dry eyes or nose, or slight constipation, honey can be added to taste. For patients with chronic dry eyes that worsen in the Autumn, make a tea by combining one teaspoon chrysanthemum flowers with one teaspoon Chinese wolfberries (i.e., Goji berries; gou qi zi 枸杞子).
During cold and flu season many simple teas can be taken to help prevent contracting the condition or to treat it in early stages. For basic prevention make a simple tea combining six grams each of schizonepeta buds (jing jie 荊芥) and perilla leaf (zi su ye 紫蘇葉). Steep them both in 8 to 10 ounces of boiling hot water and sip throughout the day. These two herbs can also be combined with regular Chinese green tea. For early stage colds that are characterized by chills, runny nose, slight headache, and maybe even nausea or lack or appetite, make a simple tea by boiling about six slices of peeled ginger root in one cup of water. For added strength, cook the ginger with several pieces of the white parts of a scallion bulb.
Because the basic flavor associated with the Metal phase and Autumn is sour, a delicious daily tea to make is simply steeping one or two slices of fresh lemon in boiling hot water. A second sour flavored beverage for the season is rose hip tea. Rose hips are the fruit of the rose plant and an excellent source of vitamin C. Not only is vitamin C an important nutrient, research suggests it can also be effective in preventing and treating the common cold (Douglas et.al. 2007). Patients with more serious conditions of seasonal allergies, the common cold, or other such conditions should seek the guidance of a licensed practitioner of acupuncture and Oriental medicine. Some current research suggests that, for example, “traditional Chinese medicinal herbs as a whole seem to be comparatively or more effective compared to different chemical drugs” in treating colds and flus (Chen et.al. 2005).
Acupressure and Patting for Autumn
Patting or beating at acupuncture points or along channels, a technique know as Pai Da (拍打), is an important method of health preservation in both Chinese medicine and Qigong circles. Since the main organ associated with the Autumn is the Lung, the hand Tai Yin Lung channel is the one we focus on this season. The Lung channel has 11 points and runs from the upper chest just next to the shoulders down to the end of the thumbs. An important point to stimulate during Autumn is Lung point number 5, Chi Ze (LU-5; 尺澤穴). Chi Ze is found in the bend of the elbow (Figure 3). To locate the point first find the biceps tendon by flexing the elbow – the biceps tendon is the main tendon that can be felt at the elbow bend while doing this. Chi Ze is found lateral to the tendon, that is to the outside of the tendon if the arm is down at the side palm facing forward. Press into this muscle area and find a tender spot, which will be the location of Chi Ze.
Chi Ze clears heat from the Lungs and downbears rebellious Qi. This means Chi Ze treats conditions such as the common cold, coughing, shortness of breath, wheezing, and fullness of the chest. It can also be used when there is sinus congestion such as with allergies. Aside from respiratory problems, Chi Ze is also used to treat pain and motor dysfunction of the arm. To stimulate, use the thumb to press deeply into the point until there is a heavy or numb sensation that moves slightly down the arm. Hold pressure for a count of 30 seconds and then release. Repeat several times throughout the day. Alternately, use an acupressure device to do the same procedure.
In addition to acupressure at Chi Ze, Pai Da is done at this point. With an open hand slap the area of Chi Ze with moderate intensity. At the beginning the technique should start more gently which is known as Wen Pai (文拍; Scholar Patting), and then progress to stronger stimulation known as Wu Pai (武拍; Military Patting). Alternate pats on the right and left sides of the body, continuing for 5 to 10 minutes (or longer). While patting, the skin of the arm will turn red. In Chinese medical terms patting draws the Yang qi to the surface of the body area being stimulated, and this is especially useful for when we have conditions where cold has entered the Lung (leading to, for example, the common cold or flu, or allergies). In addition to patting only at Chi Ze, patting down the entire Lung channel is also appropriate. For this practice, start by patting in the shoulder region and then down along the length of the entire channel reaching eventually the base of the thumb (Figure 4). Patting should be done in this direction since it is the direction that Qi moves though the channel.
Self-Reflection for Autumn
Mind and body are inseparable units. When one is diseased so is the other. As we mentioned earlier in this article, Autumn is the time for self reflection, especially self reflection that brings about inner quiet and engenders selflessness, the positive virtue of the Metal phase. One very profound yet simple method of self-reflection in the Asian tradition that does just this is the Japanese method known as Naikan.
Naikan is a practice developed by Yoshimoto Ishin based on the Japanese tradition of Jodo Shinshu (Pure Land Buddhism), and can be traced to a rather austere meditation called Mishirabe (身調べ). Yoshimoto, who himself achieved enlightenment in 1937 by practicing Mishirabe, sought to take this reflective practice and make it secular and gentle. In Naikan, the Naikansha (内観者, i.e., Naikan practitioner) reflects on their relationship with others using the framework of three questions about what they received, what they gave, and what troubles or difficulties they caused. Traditionally one begins by reflecting on their relationship with their mother over a specific time frame, the questions becoming:
1. 母親からしていただいたこと - What have I received from my mother?
2. 母親にして返したこと - What have I given to my mother?
3. 母親に迷惑をかけたこと - What troubles or difficulties did I cause my mother?
However, the subject of one’s reflections can be on any individual, and even solely on a specific period of time, as when one uses the same questions to reflect on the past day (known as Nichijo Naijan 日常內觀 – Daily Naikan). In this case, the questions remain the same, but encompass all encounters during the day with people, objects, and even forms of energy (e.g., heat or electricity).
In Japanese the word Naikan (內觀, Nei Guan in Mandarin Chinese) means “looking within.” However, when we look at the deeper meanings and connotations of the Chinese characters used to write Naikan, we understand better what the practice really does. The character Nai/Nei (內) in the Shuo Wen Jie Zi, one of the earliest dictionaries of Chinese language that dates back to the 2nd Century C.E., is defined as “to enter.” (內：入也) The second character Kan/Guan is usually in modern times translated as “look.” However in the Shuo Wen Jie Zi the definition in Chinese is is Di, “to examine” or Shi “to inspect.” (觀：諦視也) In Buddhism the same word Di also means “the truth” (such as in the “Four Noble Truths,” Si Sheng Di – 四聖諦).
In Naikan there is an intense focus on actual activities done or actual things given or received. This is done without reference to the motivation behind the giving or receiving, or the reason why trouble was caused. For example, today I received payment from my patients. The fact that I provided them with treatment in exchange does not change the fact that I benefitted from money they gave me. Likewise, my patients received treatment. The fact that they paid for it does not change that they benefitted from my labor. The particular night I started writing this essay I was running late and several patients had to wait. Even though I had a “good” reason for running late, it doesn’t change the fact that it was an inconvenience and trouble that I imposed on several of my patients.
Therefore what Naikan does is asks us to look at the objective facts of our lives. By doing so we start, sometimes for the first time, to see the truth of the whole of our lives rather than just narrow slices of our experience, or what we want or have been conditioned to see. Put together we can see why Naikan is a practical method of “entering into the truth.”
Even though we just mentioned three basic questions as the Naikan framework for reflection, we should be aware of a fourth question – “what troubles or difficulties did others cause me?” This question, known in Naikan practice as “Gaikan” (Wai Guan in Chinese 外觀), or “external viewing,” is purposely not asked during Naikan reflection. Focusing on how “I” have been wronged is, in most cases, the cause of one’s suffering. This self-focus is the fast track to missing the love, support, and grace that allows us to live at all in society. In the Shuo Wen Jie Zi, Gai/Wai is defined as yuan - to distance oneself from something. (外：遠也) Thus this fourth question, Gaikan, can be seen as something that “distances oneself from the truth.” Interestingly, modern research bears this out. Self-focused attention is associated with depression, anxiety and a wide range of other psychological disorders (Ingram, 1990). Beyond that, self-focused attention is also associated with physical disorders such as chronic pain and cardiovascular disease (Turk, 1983; Scherwitz et. al., 1986).
As an exercise for Autumn, try practicing Daily or Weekly Naikan. At the end of each day (or each week) set aside15 to 30 minutes of quiet reflection time. During that time reflect first on what you have received during that day or week. Then, focus on the second question of what you gave to others during that same day or week. Lastly (please spend about 60% of your reflection on this last question), reflect on what troubles or difficulties you have caused others during that same day or week. My own personal experience with doing Naikan is usually that I receive far more than I give, and I certainly cause a lot of difficulty for others! Doing this reflection reminds me how much I rely on the grace and kindness of many people around me almost every day, and in doing so I find it a little hard to be judgmental about others. For more information on Naikan please see Kreech (2001) or visit the ToDo Institute, the only educational institute in the United States devoted to teaching Japanese methods of psychology, including Naikan (www.todoinstitute.org).
In poetry and art Autumn is often portrayed as the seasonal embodiment of melancholy and solitude. The shortening days and dwindling light, coupled with the cooling of the weather, slows down our activity and brings us to the energetic movement of harvest. This movement also brings us into a place of quiet self-reflection, and reminds us of whence we came. Autumn was the time that made the great Chinese poet Du Fu remember and long for home. As the leaves change color and fall to the ground we are all reminded of our own impermanence, yet the ritual movement of the season goes on, and if we can stay healthy we will continue to observe this ritual transformation from Yang to Yin, and then back again during the seasons of the many years to come.
Lily Bulb Congee 百合粥
- 1 cup white rice
- 10 cups water
- 30g dry lily bulb, or 50g fresh lily bulb (百合)
- 6 Chinese red dates (紅棗)
- several slices peeled fresh ginger (生薑)
- honey to taste (optional)
- Rinse lily bulb, red dates and ginger
- Place rice, herbal ingredients and water into a pot; bring to a boil on high flame
- Reduce flame to medium low and simmer for 45 to 90 minutes, until rice starts to break apart and become creamy
- Add honey to taste (optional)
This delicious congee is perfect for Fall! It has the function of clearing heat, moistening the Lungs, and lubricating the intestines. Lily bulb also has a calming effect on the Shen and can treat agitation, insomnia or restlessness. In addition to the above ingredients, consider garnishing with sesame seeds, walnuts, or pine nuts.
Steamed Pears and Apricot Seed Dessert 燉雪梨
- 1/3 cup peeled northern Chinese apricot seeds (bei xing ren 北杏仁)
- 4 large Asian pears (about 2 ½ lbs.)
- 1/4 cup rock sugar
- Soak apricot seeds in one-half cup of water overnight, and drain in the morning
- Bring about 1 cup of water to a boil in a small pan, and simmer apricot seeds for about 4 hours until tender, reserve seeds and cooking liquid for later use
- Wash, peel, and core pears; place inside tureen with apricot seeds, their cooking liquid, 2 more cups of cold water, and rock sugar
- Place tureen inside a larger pot that has a rack on the bottom (be sure tureen does not touch the bottom or sides of the pot); fill outer pot to about 2” with cold water, bring to boil, and steam the tureen for about 2 hours (refill water to outer pot as necessary if it boils off during steaming)
- Serve pears with apricot seeds and cooking liquid (figure 5)
This is a fantastic Cantonese dish that is both delicious and therapeutically effective. This type of double boiling, or steaming the tureen, locks in moisture. Chinese apricot seeds (bei xing ren 北杏仁) can be purchased at Chinese herbal pharmacies. They are slightly bitter in flavor and are used to treat coughing and wheezing as they slightly moisten the Lungs. Asian pears are sweet, and they can moisten Lungs and protect fluids. Apricot seeds are also useful to lubricate the intestines in cases of constipation. Taken together, this is a tasty dessert that nourishes Lung fluids at the time of Autumn dryness. Please note that Chinese apricot seeds are slightly toxic, so they should be soaked as directed above and then subjected to long boiling (both of which reduce their toxicity).
Chen, X.Y. Wu, T.X. Liu, G.J. et.al. (2005) Chinese medicinal herbs for influenza. Cochrane Database Syst Rev. Jan 25;(1):CD004559.
Douglas, R.M. Hemilä, H. Chalker, E. Treacy, B. (2007) Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev. Jul 18;(3):CD000980.
Ingram, R.E. (1990) Self-focused attention in clinical disorders: review and a conceptual model. Psychol BullMar;107(2):156-176.
Knoblock, J. Riegel, J. trans. (2000) The Annals of Lü Bowei. Stanford, CA: Stanford University Press.
Krech, G. (2001) Naikan: Gratiude, Grace, and the Japanese Art of Self-Reflection. Berkeley: Stone Bridge Press.
Leung, L. et. al. (2011) Chronic constipation: an evidence-based review. J Am Board Fam Med. Jul-Aug, 24(4):436-51.
Lu, H.C. ed. 黄帝内經（素問，靈樞）難經原文（段落難号）[The Original Chinese Texts of the Huang Di Nei Jing (Su Wen, Ling Shu) and Nan Jing]. Vancouver, Canada: International College of Traditional Chinese Medicine.
Lu, H.C. trans. A Complete Translation Of The Yellow Emperor’s Classic of Internal Medicine And The Difficult Classic. Vancouver, Canada: International College of Traditional Chinese Medicine.
Pitchford, P. (2002) Healing with Whole Foods. North Atlantic Books.
Salmoirago-Blotcher, E. et.al. (2011) Constipation and risk of cardiovascular disease among postmenopausal women. Am J Med. Aug, 124(8):714-23.
Scherwitz, L. Graham, L.E. Grandits, G. Buehler, J. Billings, J. (1986) Self-involvement and coronary heart disease incidence in the multiple risk factor intervention trial. Psychosom Med Apr;48(3-4):187-199.
Sun, L.B. Wang, T. (201) 黄帝内经二十四节气饮食法 [Yellow Emperor’s Inner Classic Dietary Therapy for the 24 Seasonal Nodes]. Beijing: Chemical Industry Press.
Turk. D.C. (1983) Pain & Behavioral Medicine. New York: Guilford Press.
Unschuld, P. Tessenow, H. (2010) Huang Di Nei Jing Su Wen: An Annotated Translation of Huang Di's Inner Classic - Basic Questions. Berkeley: University of California Press.