• You are sensitive to changes in weather or dislike hot or cold sensa-tions. Someone opens the window and
you immediately are cold and angry with the person who opened it. You wear several items of clothing, socks, and muffler.
• Do you recently feel lonely or depressed despite the fact that you have family, friends, and pets? You feel alone in a crowd.
• Are you afraid of being among many people at a gathering or in society?
You worry about catching a cold, especially during the common cold or viral season. You really do not like to see your coworkers sick because you do not want to become sick from a contagious disease.
• Are you interested in new diets because whatever you eat makes you uncom-fortable? You think that your diges-tion issues are from food selecdiges-tions.
• Someone asks a favor of you, but you think, “I can’t be bothered.”
• You do not care for your appear-ance, such as your waistline, skin, or clothing; you just want to be healthy because you have been suffering from minor ailments.
• You have allergy symptoms: itching eyes, runny nose, heartburn-like sore throat, and skin allergy from weather change.
• Whenever you feel fatigue and tired, your skin problem irritates you more.
Related Conditions
• Cold sensitivity
• Fatigue and depression
• Food intolerance
• Constipation or loose stool
• Irritated skin condition
• Severe allergy symptoms (not specific with allergen)
FIGURE 5.4 Type T.
• Distal joint pain and weakness (fin-gers, wrists, toes, ankles)
• Facial swelling and arm skin condi-tion (chicken skin: keratosis pilaris)
• Feeling heavy and weight gain
• Frequent infection and inflammation
• Taking several nutritional supple-ments or herbs
• Recent blood test that is slightly low or high in the normal range
Clinical Syndrome
The type T group tends to visit health practitioners because of their health and appearance changes, whereas the type P group is more self-contained to figure out their health concerns, such as exercise, diet, meditation, nutritional supplements, and visiting a spa. If type P is manifested in the imbalance of body rhythm, type T is the broken cycle reaction in the body system, especially the metabolic pathway (Figure 5.5). Type T is a more chronic stage than type P is, and is mostly manifested in auto-nomic nervous system imbalance. If the symptom is not resolved, the symptoms and signs will begin to diversify.
The metabolic homeostasis has been dis-turbed due to autonomic nervous system imbalance. For maintaining metabolic home-ostasis, the nervous, endocrine, and vascu-lar systems are all integrated. Metabolism requires chemical balance, oxygen level bal-ance, correct temperature for enzymes, and proper removal of waste products.
Type T patients visit for treatment of the digestive system, skin eczema, and allergic reactions, especially temperature- triggered allergic symptoms. Some people are diagnosed by medical doctors as hav-ing fibromyalgia chronic pain syndrome or functional gastrointestinal disorder.
Type T is defined by the following patterns:
• Lymphatic body fluid congestion in -volving inflammation with the group of symptoms
• Skeletal muscle weakness from eccen-tric contraction; cannot push to return venous and lymphatic system
• Weakness of thoracic inspiration due to chronic physical stress that fails to help lymphatic function
Most lymph flow in the body depends on the contracting skeletal muscles and breath-ing movements, especially the inspiration resulting from diaphragm descent. Lymph flow is very slow and one directional to the central venous system through the tho-racic duct. This movement is against grav-ity. Overall, the average volume of lymph that enters the venous system is about three liters.
FIGURE 5.5 Type T mechanism.
Vigorous activity, exercise, and heavy load breathing can help to move lymph flow.
But if a physical activity is not allowed, then we need to find other pressure-generating aids. It can be an arterial pulsation, chang-ing posture, or passive compression, such as acupressure, massage, and gua sha.
Understanding the Mechanism Immune System Lymph
The lymphatic system not only prevents harmful body fluid buildup in our body, but also prevents the spread of disease. Most sys-tems of the body benefit from the lymphatic system with the balancing of fluids and immune functions. The lymph defense sys-tem fights against microorganism and disease by filtering them through the lymph nodes and destroying them with lymphocytes that migrate from blood vessels to lymph ves-sels. The defense system is widespread in the body, protecting major organs from external pathogens located in the four extremities and neck and internal organ systems such as the lungs and intestines.
For this reason, we can notice the local-ized or whole-body swelling or water accu-mulation on the area, which can be a minor inflammation or severe trauma, like a burn.
Even hormone changes can affect the lymph system, such as menstrual swelling, because with every small change in the body, nor-mal homeostatic function tries to adapt to the new circumstance, which leads to acti-vation of the homeostatic control system and negative feedback.
Transportation of Nutrient: Lymph System During digestion, the small particles of food broken down from digestive hormones
are absorbed in mostly the small intestine and transported to the bloodstream. Larger particles, such as fat, are transported by the lacteal gland, which is the lymph ves-sel, from the abdominal wall to the larger lymph system, cisterna chyli.
The lymph sac, cisterna chyli, is affected by diaphragm pressure, which means that the transport of the fat nutrients is affected by diaphragmatic breathing. When you are in a stressful sedentary lifestyle or after hav-ing a big meal, you may feel the palpitation on the upper abdominal area while lying down. The cisterna chyli is located in the lower back near the aorta.
In clinical experience, the individual suf-fering allergies and lymph drainage block-ing conditions presents with midback bending posture and spinal muscle tight-ness (T11–L2).
In TCM, the spleen’s main function is within the nutritional transportation sys-tem. If spleen Qi is weak, initially, lack of appetite, abdominal distension after eating, fatigue, loose stool, and shallow complex-ion are shown as symptoms. If it progresses to the chronic stage, dampness occurs, which leads to nausea, feeling stuffiness in the chest, and heaviness in the extremi-ties. Treatments are specifically related to each condition. It can also be developed as a spleen yang deficiency. The spleen yang deficiency symptoms are added cold feeling and dampness in the body (edema), includ-ing all spleen Qi deficiency symptoms.
The epigastric area is packed with organs, large blood vessels, and important glands.
In addition, the nutrients’ lymphatic fluids are waiting for the diaphragmatic action. If it is not working properly, epigastric conges-tion may occur, and can restrict breathing muscle movement. Once the breathing and circulation system is altered, then
the thermoregulatory mechanism starts to change.
Unlike other yang deficiencies, spleen yang deficiency directly affects widespread edema due to the involvement of the respi-ratory and circulatory system.
Lymph Fluid Accumulation
Another important role of the lymphatic system is to transport proteins from the interstitial space within a tissue or organ.
If the transport capacity of the lymphatic system is reduced, proteins and other sub-stances accumulate in the interstitium (an interstitial space within a tissue or organ).
Especially, accumulated proteins attract water, which creates high-protein swell-ing in the subcutaneous tissues, called lymphedema.
Lymphedema is a slow-onset condition occurring when body systems recover from accidents, trauma, chronic disorder, or pro-gressive disease characterized by an asym-metrical, inflammatory swelling traveling distal to proximal. Any body part may be affected, including limbs, trunk, head and neck, and even the genitals.
This condition involves capillary blood vessels and lymphatic vessels. Drainage is one of the lymph system’s roles. While collecting the extracellular water (includ-ing waste products, dead cells, and bacte-ria), lymph vessels tend to be accompanied with veins, except in the abdominal cav-ity. The lymph and venous system depend on skeletal muscle movement because they do not have their own pump to reach the upper cervical area. Thus, healthy muscle tone, adequate movement during the day, full range of diaphragmatic breathing, and peripheral blood circulation are important to prevent accumulation of lymph fluid in
the body. Prevention for the accumulation of body fluids includes
• Healthy muscles (neutral state, ability to relax and contract)
• Active body work, movement, action, and exercise
• Good quality of breathing and blood circulation
• A good source of nutrition and a healthy digestive system
• For a healthy digestive system, ade-quate rest and sleep time
Venous Insufficiency
Skeletal muscle movement pump action is an important factor for venous return, as well as lymphatic fluid movement. Venous return occurs with skeletal muscle pump in the extremities and respiratory activ-ity in the abdominal thoracic area. If it is not working properly, venous insufficiency begins in the legs, which are swollen, skin is darkened (hyperpigmentation), skin thick-ening occurs (lipodermatosclerosis), or an ulcer forms near the ankle.
Individuals from the type T group pres-ent with swollen legs and vein problems, such as spider veins and varicose veins, in the initial stages. If this condition is not resolved, the muscle will change to a string-like shape and painful tension will build up in the leg and ankle area. This leads the walking-gait limitation of the feet.
Gaining Weight
You have been busy, with not much time to take care of yourself. Long-term distur-bances made your immune system weak and gave you a minor disorder. Hovering between well-being and disease, you can
continue your stressful daily life, but you feel tired and overwhelmed. This is the point where we are blocked from seeing our own appearance. We are too busy to see the mirror, too busy to check the waist, and too busy to treat a headache. Gaining weight is not because of your lazy lifestyle or eating too much. You did not have a chance to take care of your inner or outer broken cycle and rhythm.
Pain
Individuals in type T do not complain of pain during the initial stage. The more con-cerning issues are fatigue, allergy reaction, skin problems, and digestive issues. While they visit my clinic and have treatment for those issues, the pain symptoms occur from an unexpected area or whole-body pain.
This happens frequently in acupuncture clinics. After treatment, patients have body pain and feel weak and tired. Since type T usually progresses to type P, due to broken biorhythm, the body has been holding the tension and stress chronically and cannot resolve it or move to the relaxed stage by themselves.
This happens during the weekend after intense and stressful work, or vacation sickness after a long-term project is com-pleted. The symptoms are usually shown as cold, allergy, or whole-body ache. Type T patients need to be instructed and informed about what symptoms to expect after treatments. If the body has been stressed for a long time, the hyperstage becomes normal for the body. So, even though the body does go into a relaxed stage, the person feels ill or depressed in his or her hyperadapted body. This body pain is not too severe in its first occur-rence, but later it possibly develops to
chronic fatigue syndrome (CFS) or fibro-myalgia if accompanied with hormone changes or body fluid loss in certain conditions.
CFS is a disorder that causes you to become so fatigued (tired) you cannot per-form normal daily tasks. This is called chronic fatigue. The main symptom of CFS is chronic fatigue that lasts more than six months. Physical or mental activities often make the symptoms worse, and rest usually does not improve the symptoms.
People who have CFS may experience the following symptoms:
• Fatigue
• Headaches
• Sore throat
• Tender or painful areas in the neck or armpits due to swollen lymph nodes (or lymph glands)
• Muscle soreness
• Pain that moves from joint to joint without swelling or redness
• Loss of memory or concentration
• Trouble sleeping
• Extreme tiredness after exercising that lasts more than 24 hours
These and other symptoms often will not go away or keep coming back for six months or more.
CFS may occur after an illness (such as a cold), or it can start during or shortly after a period of high stress. It can also come on slowly without any clear starting point or any obvious cause. In some cases, CFS can last for years.
In TCM, this stage arises from spleen Qi deficiency and damp accumulation, which leads to the dense formed condition of phlegm with heat-generating form, the continued chronic stress. In other words,
damp heat easily dries up body fluids and condenses it as phlegm. There are two dif-ferent phlegm categories, substantial and insubstantial phlegm. Substantial phlegm is visible, such as when coughing or vomiting.
Insubstantial phlegm is often the conse-quence of internal disruption of the body’s fluid metabolism.
Once phlegm has occurred in the body, the pathogens will be unpredictable and will involve various symptoms, so it is known as a notorious pathogen to treat and diagnose because it results from the disturbance of homeostatic balance and affects metabolic homeostasis.
Postural Characteristics
The first impression of type T is a “square”
body shape, and the extremities are weak and thin, whether the person is lean or looks overweight. This is because his or her lymph body fluids are congested and the lymphatic drainage system is affected. The upper back, armpits, lower abdomen to thigh, and side of the body are the major congestion areas.
He or she may have a forward stoop, but this is not related to spinal deformity such as kyphosis, but looks as though the entire body leans forward, including neck and head.
Possible Associated Disorders
• Chronic fatigue syndrome
• Fibromyalgia
• Multiple chemical sensitivities
• Chronic mononucleosis
• Orthostatic intolerance
• Irritable bowel syndrome
• Interstitial cystitis
• TMJ pain
• Chronic pelvic pain
Treatment
Type T patients are treated with “press and depress” methods in my clinic. They include hydrostatic pressure, negative pres-sure, releasing muscle tension, tightening of the skin, and encouraging emotion from the depression.
The stage of type T is the next level of type P which is dominated from stress stage.
Unresolved tension is due to chronic inflam-mation or local congestion, which is shown as swollen or depressed surfaces. Sometimes patients think that it is “fat” on their back, thighs, or arms. However, the area has a tight muscle or scar tissue underneath and the gap between the skin and muscle is thicker than in other parts of the body. That is the point of muscle meridian needling. Type T is influ-enced on foot yang muscle tendon meridians.
In understanding the structure, type M2 has been introduced as inner tension pushed out to exterior surfaces and the body outer shell being adapted as the transforma-tion of the spine and skin area. Type T is the opposite action. The outer surface’s con-gestion and tension buildup tend to push inward and restrict the normal movement inside, especially the digestive and respira-tory systems.
For example, the stretch mark is usually on the surface area from the tension of inter-nal change, such as pregnancy or local swell-ing. After resolving the internal congestion or delivery, the stretch mark areas remain as the depressed extra skin surface initially, and then later, they gradually build up as thick tight tissue, which can restrict the inner functional movement, such as breath-ing. Therefore, the chronic stage of type T treatment is similar to that of type M2.
The digestive and respiratory systems are the core of the press and depress system.
Two major parts are treated at the same time. Type T symptoms and signs are pre-sented as various and hard to distinguish at one glance. However, we cannot miss the important point for this syndrome from chronic stress, which can affect the diges-tive system and the circulatory breathing system.
The core treatment, restoring the diges-tive system, will be emphasized in type T.
So, in each treatment session, facial and neck treatment or GIR treatment for restor-ing the digestive system is followed by mus-cle meridian treatment.
Type T treatment is not simple with a quick response. It takes several months to years, depending on the symptoms and signs.
Simple Home Care and Cautions
Type T is involved with many aspects of metabolic homeostatic function, and one or two factors are not working well. The important thing is that it took a long time for this stage to develop from a state of imbalance to where your body had adapted to its new environment. Therefore, it is unrealistic to expect quick results and big changes right away. However, if you do not give up, then your comfortable, healthy state will be restored. Keep this in mind as your long-term goal for your health.
Before your body adapts to its broken cyclic balance, you need to regulate it with habit change.
At first, the stressor is removed. If it is impossible to avoid it, you need to regulate your habit with other things instead.
For type T, nighttime is crucial for recovery of the basic metabolic system. Spend more time on yourself, at least 30 minutes every
day. Fix your bedtime around 11:00 p.m.
and before bedtime, you need to spend one hour of private time for you. Soak your feet in warm water, pamper your face and neck for a while, or take a warm half-body bath for 20 minutes until you have forehead sweat.
It may be not easy to have a good sleep every time; sometimes you will wake up at 2:00 a.m. or 3:00 a.m. It is fine, and do not worry about that since you will sleep well the next day. Do not take note of what time you wake up or how long you slept; you just need to focus on your fixed bedtime.
Breakfast is vital and your first meal should be solid food. You need to use your masseter muscle for mastication. Drinking only coffee, milk, or juice is not considered breakfast. Especially, if you feel muzzy in your head, struggle to concentrate, or have brain fog, you need to eat warm solid food at breakfast time. If you have been skip-ping breakfast and have no appetite in the morning, instead skip dinner or eat earlier in the evening from now on. The first sev-eral days will be challenging, but your body will adapt sooner than you expect. When it comes to meal portions, instead of a “bully-ing diet,” reduce your portion sizes. Instead
Breakfast is vital and your first meal should be solid food. You need to use your masseter muscle for mastication. Drinking only coffee, milk, or juice is not considered breakfast. Especially, if you feel muzzy in your head, struggle to concentrate, or have brain fog, you need to eat warm solid food at breakfast time. If you have been skip-ping breakfast and have no appetite in the morning, instead skip dinner or eat earlier in the evening from now on. The first sev-eral days will be challenging, but your body will adapt sooner than you expect. When it comes to meal portions, instead of a “bully-ing diet,” reduce your portion sizes. Instead