Episode 8: Thomas Kouo

    Posted by Samad Saifudin on Apr 1, 2020 12:14:33 AM
    Samad Saifudin
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    This week we are joined by Thomas Kouo to discuss integrative medicine. 

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    An excellent interview with Thomas Kouo. 

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    Transcript:

    Speaker 1 (00:04):

    Integrative medicine has been around for thousands of years and is now a widely used form of healthcare across the modern world. In this podcast, we discuss holistic wellness and share how integrative medicine has evolved to become a part of our culture today. This is all things integrative brought to you by Virginia university of integrated medicine.

    Speaker: Thomas Kouo (00:33):

    Hi, my name is Thomas Kouo. I am a Doctor of Acupuncture and Oriental Medicine, DAOM program, a long time ago I think back here, we were one of the first cohorts here of that particular program. And I've been practicing Chinese medicine for a little while now. Interestingly enough, I started in gynecology. I never really had an interest in that, but my first office was two doors down from the birth center. So I, you know, just starting I remember I was sitting in my office on a Friday and one of the women, who she was the hypnobirthing teacher, was also pregnant and she came in too, she was being induced on Monday. It was a Friday. And she said, you know, do you do labor inductions? And you know, when you starting, you do everything, right?

    Speaker: Thomas Kouo (01:21):

    I said, "Oh yeah, of course I do." Right. I had no idea. So I said, "I'll come back tomorrow, you know, give me some time to look it up." Exactly. And, so I don't know if what I did had anything to do, but she did give birth on the Sunday. And so I started getting a lot of the patients and then what happened was I just started treating their children because they would bring the children in. And so pediatrics became kind of the second specialty that I dealt with. As the children grew up, they started to you know, get involved in things like athletics. One ended up being an Olympic gymnast. And I learned a lot from treating him and got into more of the sports medicine, which is what I thought it was going to be doing.

    Speaker: Thomas Kouo (02:05):

    Right. I wanted to be the acupuncturist for the New York Knicks, right. And, someday, right. They could use it for sure. So that was really kind of my background. I really loved the classical medicine. I think, you know I think that ultimately speaking, you know, when we get back into the classics I think is the least limiting, right? Because we don't have, we don't have any self-imposed perspectives that we have to adhere to. It just simply is what it is. Right? And in that, it's the most pliable. Each branch system that we have, each is really beautiful in its own way. It is also limited. Right. And so my thing has always been to learn as much as you can, you know, and I think I know a little bit about a lot of them.

    Speaker: Thomas Kouo (02:58):

    I wouldn't, I would never think I'm an expert in any of them. And you know, as you know, this medicine really none of us are really experts. Yeah, exactly. We were just all trying to learn that. I got into education. I'm currently the Dean at the Eastern School of Acupuncture and Traditional Medicine in Bloomfield, New Jersey. Now, New Jersey, we only have one school that is a full school. Virginia is also up there. And maybe up there, on a larger scale, hopefully soon. Which I think would be great. I think the state needs more. It's just, it's a difficult state, you know, just because it's New Jersey and everything's difficult in New Jersey. But I got into education because I think that, you know, you see a specific way that the medicine is moving into and I think, we want to really do our part to help direct that, and to really make sure that the next generation of practitioners are better than we are and that they're able to add and correct our mistakes and add more to the mess and translate more give more.

    Speaker: Thomas Kouo (04:07):

    And so that was what really attracted me to the educational aspect. Educational administration sort of just fell into that. But sort of, you know, how I got here and again, happy to be here. So great. Thank you. Integrative medicine, I think you have a couple of ways to look at integrative medicine. Integrative medicine can be, in the way I look at it is really, you know, a table in which you have people with multiple perspectives can sit down. Even you and I, we are in the same field. And yet we provide different perspectives and if we work together, that's integrative medicine. To me, it's not simply Western medicine, Eastern medicine, but different perspectives. And so a table in which we are able to bring multiple perspectives into the common cause of helping make people's lives better.

    Speaker: Thomas Kouo (05:01):

    That to me is what integrative medicine is. The other possibility, I guess is integrative medicine in some places of our field has sort of defined it as taking our medicine and reshaping it and evolving it in a way that involves different perspectives. So, TCM, for example, is a movement of integrative medicine. It was made for Western medical practitioners. And so it was a westernized version of Chinese medicine, a very simplified, westernized version. So that's another way you can look at integrative medicine, the same, evolving or changing our medicine to involve other perspectives. The reason why I don't necessarily prescribe to that, and I appreciate it very much, is because I think that we get more by bringing more different perspectives versus like for example, my sister's a Western medical doctor. I wouldn't dare bring Western medicine to her because I would just be humbled in the first 10 seconds.

    Speaker: Thomas Kouo (06:05):

    And so when I first worked in the hospital system, I worked at UCST, and the attending physician there said something to me that has always stuck with me. I said, "what do you want from me? What do you need from me here and what, what's my job?" I said another, and he said this, and he said, "I want you to bring to my patients something that I can't." And I always remember that. And because of that, that's really shaped the way that I think of what integrative medicine is, is that we are trying to bring something entirely different, not better, not worse, just different. And so our approach along with the other approaches that are sitting at that metaphorical table are what allow us to comprehensively look at and holistically deal with people's health conditions.

    Speaker: Thomas Kouo (06:59):

    And I think that's where we have our best chance to make a difference. So, that's sort of how I see it. Thank you. Well, I'm actually really glad that Jeff's here. We have immunology and Chinese medicine is sort of a difficult topic because when you go back and you look for source material, there's not a particular source, so it's not, you don't have like the classic of immunology for example, you have bits and pieces of within the classical test. So how do you need gene for example, chapter 72 talks about just the "Jing Qi", we call it a registry and how that that is going to protect the body from invaders and silver. So sort of outlines the idea or what we think of as the immune system without really putting a definitive definition on it, you know, and so we look at things here and there.

    Speaker: Thomas Kouo (07:49):

    So it's a great discussion because we have to sort of piece things together and you know, Jeff also has some expertise in the classical five element style, which is a different perspective. So again, hopefully we'll be able to get some talk about that. Looking at it from different ways and by looking at this idea of immunology from a kind of grand perspective in the many paradigms of others' medicine, maybe we get a better idea of what it actually is and how to understand it, how to utilize it to be able to help patients in either as a first line defense, second line defense or whatever. However we can fit into, you know, into people's health care. Just as a general perspective, I think when we look at the immune system, we're immunology in Chinese medicine.

    Speaker: Thomas Kouo (08:38):

    We really, it is a, I was just telling Jeff earlier, there's two ways of looking at it in one way it's very simple. It's simply how do we protect your body? You know, things from the outside or invaders are going to come in. And from a Western perspective, we look at things like we call them antigens, like in Chinese medicine antigen simply are what we call the "Liù dà zuì'è", which is the six evils right there, hot, cold, dry decks, right? And so essentially just different names, but they're antigens right. Antigens by in Western medicine is a kind of a broad topic of broadened name of many different kinds of evils, bacteria, virus, whatever, that are going to attack the body. And the body reacts in the ways that it does. And in Chinese medicine, again, we have a very general, because of the way they combined create different types of things that will attack the body.

    Speaker: Thomas Kouo (09:34):

    So really that's a very common type thing. We just simply name it differently, you know? So in one case it's, you know, immunology is very simple, you know, but I think the more you look into it, the more you get into the mechanisms, you know. Western medicine when you're looking to immunology become just a, because their headache of, Oh my gosh, so many, so many things. And like all these cytokines, B cells, T cells, and so specific that it is an entire study on himself. And then with Tian medicine really the mechanisms by which we are able to cover the functionality of all that manusha, which it does is again, is not necessarily written. It comes from understanding the physiology of the body and really saying, okay, if this happens, then how do we end up here?

    Speaker: Thomas Kouo (10:32):

    And then part of it is, I don't want to say guessing, but part of it is just through saying, okay, this is how the body works and if it's attack, how does the body react? And then figuring it out, you know. And so certain terms we have, for example we have, I mentioned before, we call it "Jing Qi". Jing Qi with the G is what we call the righteous Qi. Righteous Qi is a, is sort of a larger type of idea. Qi is Qi, but when we have qualifiers, we call things different kinds of. Jing tells us where it is and what it's doing essentially. Right? The righteous Qǐ is sort of a, is a larger idea of the body's anti pathogenic factor. Right? So you have pattern that had the model, we have the, we have what fights against that.

    Speaker: Thomas Kouo (11:20):

    So it's sort of kind of this big idea when we think of in TCM, at least when we think of the immune system, I think, especially at our master's levelsand some of just the very direct thinking, we go to what we call defensive Qǐ, waits Qǐ, right. And which is part of the righteous Qǐ. So the way Qǐ is we call defensive Qǐ, which travels in a couple places, most notably on the outs exterior the body. So the X flows around, the exterior of the body protects against things trying to get in. But we also have what we call the Wei Qi flows on the inside of the body. So you know how we have the Ren and the Du Mai, right? So the Ren flows in the front. The Du Mai flows in the back. But the Du Mai also flows in the front behind the Ren Mai, right?

    Speaker: Thomas Kouo (12:04):

    So we have like a circular thing and the Du Mai or the Ren in the back as well. Right? So, it doesn't just stop, it's not just one thing, but a entire circular thing. So the same thing with the Wei she Wei Qi travels on the outside, but also is on the inside of the body that travels on the outside of the blood vessels because we have a balance called the Wei in the Ying, which is the constructive nutritive idol. Many dumb names, but, the Qi basically the Ying Qi constructive Qi is the Qi that pushes the blood, right? So it's the young aspect of the blood. So it moves, right? The blood is itself a very nutritive, but without circulation it has no function. So without that movement, that movement is, created by the, the nutritive Qi.

    Speaker: Thomas Kouo (12:50):

    So we have that on the outside or on the inside of the blood vessels and at the outside of the actual vessel, we also have the Wei Qi flow, right? So we have that, we have that kind of balance there. And then we have what we call the Wei Ying Qi with the outside Ying Qi which travels on through the blood vessels, right? We have them different level of the acupuncture vessels. We have the superficial, which is the skin. And then below that we have what we call the blood vesselswhere blood flows. And blood flows, you need circulation, which means the Ying Qi also flows there. So we see that that's on the more surface level. So the interior exterior, but interior ends up exterior and exterior end up interior. And so when we look at something like Wei Qi, we look and say, well, that's a big part of our defense.

    Speaker: Thomas Kouo (13:37):

    When we go to the deeper levels, we want to understand, well where does that come from? Right? Well how does it get there and what is it really other than just its function? And we know that Wei Qi is one of the many Qi, that is differentiated from the here, which in Western medicine is where behind the breastbone is located, the thymus gland, right? The thymus gland, which if I, again, Western medicine is not my thing, but I believe that this is where I think T-cells mature in here and we look and think about that, then they're differentiated out into the body through the blood vessels with the blood from the thymus gland. Right? And so we think that this is rent 17, right? Or we have a point here called rent 17, which is we say is the influential point of Qi because this is where Qi is formed essentially, right?

    Speaker: Thomas Kouo (14:31):

    We have what we call Da Qi, which is the great Qi or the air Qi heavenly Qi, which is very fine as we breathe in, right? And so it's not very substantial, very light area and so forth. And then we have the we see the essence of the food and grains. So the good parts of what we get from food depending on what we eat, right? It could be either really good or in my case, probably not so good, but either way, it's the coarser part of the young Qi stuff that combines here. Because we look at the Qi from the food, which is the coarse Qi it by itself. We say, well, we call it Gu Qi, Gu Qi in the body. What function does it have? Well, nothing by itself. Right? And then also the air that, the heavenly Qi, the air, even though we know air is important from Western medicine, Da Qi by itself in the body has no function.

    Speaker: Thomas Kouo (15:26):

    Right? But when they combined here and be called Zong Qi right. They called gathering Qi, chest Qi and sister Qi or so many names, right? But that Qi wants, that combines here we have now we have a yin and yang where we have coarse and we have the light, I guess, coarse. And if we think about that, because Qi has to go different places. So if you think about that, you have different, because Qi though is not really substantial has form right? And so if you have Qi that needs to go to the outside of the exterior of the body, then this shouldn't be your course heavy dense as it relates to Qi because it can't sustain that out here. Right? So that heavy food, grain dense Qi really is more of the Ying Qi that travels with the blood because, exactly. Because now it has more mass.

    Speaker: Thomas Kouo (16:15):

    It can push the blood, right? It's more substantial, that light area stuff that's going to come out to float to the surface to protect the body. Now what's interesting about this is that this allows, if we think about this mechanism, and so, okay, that's how, that's where our Qi goes. And then we of course from here also goes to lung nine. Right? That's where it starts our circulation of Qi in the channels. But if we think about this, if we have what we call the balance of the human way, right? This is a very herbal concept, but, and yeah, it's a very important time, a mental concept. There's, in acupuncture programs, we don't always emphasize this balance, right? We talk about it, but then we don't really utilize that concept much because we were just kind of, you know, puppy meridians and things like that.

    Speaker: Thomas Kouo (17:07):

    Five element. Of course we're looking at, you know, color, sound, order, emotion and those things. And if when one becomes weak, whether the exterior, the interior become weak, then essentially you have that balance, which means if the exterior becomes weak, the way she becomes weak, we don't, we're not breathing well or we have a poor air where we asthma or whatever it is, right? And we don't have a lot of that light heavenly Qi to float up to the exterior. Then the Ying Qi, the course will have to come out temporarily at least to to defend because that's the main thing is stay, that which is not me, not self please stay out, right? So it does that. But in cases of where we have sustained or permanent damage in which that balance between the course and define get reversed and we have that course having to go out to the exterior and remain there.

    Speaker: Thomas Kouo (18:06):

    Then you have to think about if you have a weird tolerant, you have like a 300 pounder, right? And 300 pounder is sitting on Ty under our roof made of thin glass. At some point he's going to break that glass and when he does that, 300 pounder is going to fall and it's going to fall fast, right? And so in the same way we're looking at the course Qi on the exterior that cannot be sustained there over time. If it falls through that glass, it is going to, it's going to be fall into the interior of the body and take anything that in its way with it, right? So if you think about that falling to the interior of the body, the interior, the body is really how we look at self, right? That that's what's on the exterior, maybe superficially, but what we are and our physiology is on the interior of the body.

    Speaker: Thomas Kouo (18:56):

    So if we have something from the exterior falling harshly, strongly to the interior of the body, the damage that can occur can be akin to the body's Qi, which is the course Qi not's supposed to be there but it's there attacking itself, which would be auto immunity, right? So again, now understanding the mechanism by which the body works. Again, I don't know if this is actually what autoimmunity is, but it allows us the physiology that we have in this medicine allows us to have a different way to understand or a way to understand autoimmunity. Cause autoimmunity, we just don't get it right. So here we have a way to think about it and why that's good is because if we can come up with a weaker path on mechanism, a mechanism of the pathology of how it happened, and we know that, then that gives us a good shot to be able to reverse a debility treat it.

    Speaker: Thomas Kouo (19:56):

    Right. Yeah. I mean, curious like from a, so I have a little bit experienced with five element, but not a lot in the end to be honest. When I used five element I had never used it for like internal medicineand five element have my understanding. So if I speak, I've turned, but my understanding of that 500 basically treat anything. I mean, I know that when I used it, I found it very effective for a more effective than the things that, the other things that I was trying for things like psycho emotional stuff. And I know it's famous for that, but you know, we don't want it to be limited to that, but I'm curious. I don't really understand. Like how would you look at somebody like immune system or immunity through that lens? I have color

    Speaker: Jeff Millison (20:48):

    Sound over emotion and, so yeah. I guess the first thing I would say is that was a really interesting sort of exposition sort of when Chinese medical physiology just went through. And I actually learned quite a bit. And I think that one of the, and I'm by no means an expert in five of them. And although that's part of my training, I would consider myself sort of a TCM five element sort of synthesis, if you will. But I think that in speaking about how five element would approach immunology, sort of the immune system in some ways becomes a window to talk about. One of the ways, the distinctions between Chinese medicine as a whole and Western medicine and that is to say that Western medicine, I think at its best is treating diseases. You know, if there's an issue, you're, you know, you have a medicine or a surgery or a technique to essentially address that issue, which as you and I talked about before, we started taping.

    Speaker: Jeff Millison (21:52):

    It's more of an allopathic approach. I mean, aloe meanings sort of opposite different than homeopathy, which is same. And so allopathic approach if you're having immunological symptoms would be to treat the symptoms essentially. But what I think is a strong suit of Chinese medicine is the concept of strengthening one's basic constitution. And so the difference there would be, and there are, I guess I'd say that in Western medicine there is a subset of Western medicine that's developed and gotten more popular over the last 20 years called functional medicine. And the concept of functional medicine is rather than just treating diseases, it's about strengthening one's function and strengthening is one's ability to heal our system, to heal itself basically. And that functional medicine from a Western medical standpoint is actually the most akin, I think, to Chinese medicine because Chinese medicine, while it certainly can treat individual symptoms and I think can do it quite well, I think one of the things that sets Chinese medicine apart is this idea of just overall strengthening a person's constitutional strengthening, you know, one's motor strengthening one's physiology essentially because our systems, our bodies are self-regulating when they're working well and when they're not working well, then we become more vulnerable.

    Speaker: Jeff Millison (23:19):

    So ultimately the symptoms. So back to your initial question, I mean I think from a five element standpoint, it's less about treating individuals symptoms and more about what is the best pathway or what's the best approach to strengthen a person's symptoms so that they're firing on all cylinders to use a mechanistic metaphor so that they can self regulate so that their immune system can be strengthened and can deal with whatever the pathogen is that either is trying to get in or is already in essentially. And to me that is one of the great uses of acupuncture. I mean there are people, and this is true in five element, but I think it's true in a TCM as well. Patients sometimes come to an acupuncturist to stay well for the most part, you don't usually go to a Western medical provider to stay well.

    Speaker: Jeff Millison (24:11):

    You'd go for a checkup to make sure that there's nothing wrong that you might not be able to know that you're not seeing, but there's nothing that they're doing per se that is building your overall sort of sense of health and vitality and constitution. It's more just checking to see if there's something wrong that they can fix essentially. But one of the benefits of Chinese medicine and there's other modalities as well in a similar fashion is this concept that you can actually get an acupuncture treatment. You can go to an acupuncturist and get an acupuncture and herbal treatment to really stay well, to keep vital. And it's not unlike some of the basic things that your parents, you know, one's parents tell you. It's just like, how do you deal with like how do you make sure if you want to not get sick during the year, you know, to boost your immune system, what do people ever, parents or guardians talk about it?

    Speaker: Jeff Millison (25:05):

    They talk about like get enough sleep, get enough fluids, try to eat decently, cut down on cheeseburgers and milkshakes and get some exercise and try to, you know, try to deal with stress, through meditation or it's just anxiety or sort of stress reduction sort of techniques. And if you do those basic building block concepts, then that in and of itself strengthens your blank. And in Western medicine you'd say sort of strengthens your immune system in an acupuncture standpoint. We all talk about immune system, but it strengthens your Qi. It strengthens your Wei Qi and your Zong Qi, some of you would just going through. So I think that that's one of the big distinctions from an integrative medicine standpoint. Like how the two systems, Western medicine and Chinese medicine sort of come together. It's this combination of like building constitution, building function and capacity with, when needed to address individual symptoms.

    Speaker: Thomas Kouo (26:06):

    I love that. I think where we can get a lot of that. You know, I'd love that you brought a functional medicine cause like I've heard a lot of people talk about and I would agree with you and these full fossil that that's really where that's a bridge. Exactly. And the general recommendations that you're talking about things like you said, sleep well, drink water and stay hydrated. We sort of again, those are very universal and for a reason, you know, obviously we can look at from Western medicine, sleep is important for, you know, whatever body regeneration. We also look at Chinese medicine as well. Then we can also go back to the physiology and say, well why is that also good in our medicine? Because again, what happens is that there is a link to the physiology and the systems within Chinese medicine in which that also brings us back to all their stuff.

    Speaker: Thomas Kouo (27:00):

    So, for example, sleep right, we know sleep. The idea of sleep is a lesson we get from the shall Hanlon and I shall Hanlon in the, we call it the [inaudible] stage. Shouting stage has two kinds of stages that they have the hot stage and the cold state in the hot stage of the Shaolin, which is shown on stage, basically kidney and spleen, young deficiency, which is called, but there's also the deficiency heat of the heart mind. And so what you find is you find that John Dony who wrote shall, um, he prescribes a formula called [inaudible] in Delta quality and it is Coptis, which is a very cold and bitter, very cold and bitter likey like you don't want to be giving to pregnant women don't want me giving to anyone who is weak, just too, too cold. And yet he gives us to somebody at a stage of kidney young efficiency, which doesn't make sense, right?

    Speaker: Thomas Kouo (27:52):

    Cause you're like, young deficiency only give you this really cold and bitter. That's going to kill the spleen and it's going to be cold for somebody that called. And the reason why he does it is to clear that heart heat. Why? Why is it important to clear that heart? He's so much that you're going to give her like wow, only in that at that point. Because if you don't, if you don't clear that heart heat, you cannot sleep. And so you cannot, and if you cannot sleep, what we understand from Chinese medical physiology is that the young cheat, you get it for a couple of ways. One is the sun or you go outside and you know the Superman, right? And you can be right. And then the other one is to sleep. You cannot regenerate young sheet unless you sleep [inaudible] so you can, you can give like formula till the cows come home if you're not sleeping.

    Speaker: Thomas Kouo (28:38):

    Young cheat doesn't regenerate. So only teaches us that by, by showing us how important it is by giving these kinds of herbs in a, in a, in a situation where somebody's deficient, right? So on the same token, we say, well, if young she young, she's a broad term, right? Both of which weight she junk, she [inaudible] she all are part of that gung cheek. Right? And so if that can't regenerate unless we have sleep, then again, the same recommendation as Western medicine tells her functional medicine tells us or all the medicines tell us that is absolutely required and change this. And also, and there's a mechanism as to why and that's important. You saw, you talked about the fluids, right? We would drink fluids in Western medicine we know that helps to flush the system and so forth. In Chinese medicine we looking, so okay water, we have fluid with thick and thin fluid Jean year, weeks, way and, and water that we drink in can, can differentiate into both.

    Speaker: Thomas Kouo (29:36):

    But where essentially does it have to do with the body's is in this area of the body. We call the toll Leah told me is that we call the interspaces, right? So between the skin and the muscles and basically where the water flows. So that's where the, because of the water, you know, it, it, it helps our hair become nice and, and, and, and our, our skin to not be dry. And that that fluid comes from the water that flows through the Tulia, which is why, for example, when we sweat or we cause sweating to, to read these pathogens, essentially all we do is we boost the young, right? So we, we, we, we move young, which is going to move it upward and outward, but it moves upward and outward to the tall area where the water's flowing. So as we push young out, it can't get out unless it pushes through the water.

    Speaker: Thomas Kouo (30:29):

    So if it pushes through water and it gets out, it's going to push water out, right? Isn't that, that's our sweat, right? So if we think about that, then that water that flows into that Sully area is, is a nother line of defense because we think about how to penetrate air versus how to penetrate water. Obviously more substantial, right? So we have a, we have a fluid defense also, which is, which is, you know, able to trap things in fluids. Like, like Lim for example, lymph nodes and so forth I think has to do with this. Like, cause we don't really have like lymph or lymph nodes or but, but if you look at like its functions, I feel like it's got to be related to to that water, mud or water flow within the total, the area which, which again helps to flush the body, flush the system, help to protect it from all of those antigens and so forth.

    Speaker: Thomas Kouo (31:19):

    So it entraps it. Right. And so, so I think that, you know, if we, if we look at that, then we need the fluids we need to drink to be able to make sure that the fluids are flowing in that area. Because I mean we have that entire entire space in our entire body. So we need fluids. If we're dry, that becomes dry. Then that space essentially becomes more open. If you're open, then it's easier to penetrate in, right? Once you penetrate and we're now we're down to the muscle there now down a muscle there, all we have to do is get by the muscles and we're in the interior of the body. So, so, so again, then that same kind of recommendation that, that we hear and most of the time we just kind of like, yeah, okay, drink this. Why does, why does chicken soup work?

    Speaker: Thomas Kouo (32:01):

    Right? Grandma's chicken Sylvie's like is it magic? Maybe. Right. But, but another part of it is, is it's fluid and it's hot fluid, right? So it's hot fluids. So, so you, how you drink fluid, which is a yin, so it's heavy, you must have sink down and yet it's hot. So you have young in there, which helps push it up, right? And then it ends and we replenish that, that fluid in that totally helps to create that or that flow of defense there as well. So, so again, you know, it's a, it's another aspect of, of looking and say, okay, well this is why I think it's really interesting to say, well, let's actually not separate Western medicine, Chinese medicine, let's, let's use it to inform us. Okay. Now there's certain things we don't have answers for. Like, like Schumer only renewed we we're talking about, right?

    Speaker: Thomas Kouo (32:49):

    Like the vaccination. So like we've talked about that later, but, but vaccinations where we can sort of become sensitized to something where we remember it and the body no longer has a problem with that, but we don't really have anything like that. Like that. Yeah. I can't, I've, I thought hard about like, is there a way to, to think about that kind of a way? Immune like the memory, I just don't, again, somebody will or will not. Somebody smarter than me will figure it out, but I just can't figure that out yet. But but, and yet the mechanisms are still there to deal with it on a time by time basis. So you're still, it's not like we like that, like we how we get invaded and then we're, we were, we have no, no idea the same systems in there that helps to kick it out if it can, you know, you have to deal with how strong you are versus how strong the, the, the, the, the pestilence, well, pestilence doesn't matter.

    Speaker: Thomas Kouo (33:42):

    Both the how, how, how the, the apprenticeships. It's, and so that is the big distinction. Yeah. And again, we think about that in the Neijing. They clearly state, they say, well, if you are strong or stronger than the pestilence, you're fine. Sorry. Apprenticeships if you are if you are not, then you're going to get sick. Right. And then they later on in the, when we were looking at later in the, when being type of ideas and talked about pestilence, pestilence they talk about it. But the, the, the idea of pestilence we call lead, she leads, she is, is is more like the idea of like the Corona virus, SARS. You know, the 2003 SARS, that, that was really bad. And these ideas that, and even like swine flu or swine flu, I remember when I was in clinic, it's like everybody's like swine flu, slide, flu, lifeless life IRR.

    Speaker: Thomas Kouo (34:39):

    I'd go home and I'd be like, I'm going to get the sweater know, cause I was not allowed to not get this. Everybody has time for it. And that's the thing. But if you look at the statistics like less people died of swine flu then of regular influencer. The problem is everybody got him. Right. And I think looking at it like this, the coronavirus we have now, they are calling SARS too. Like coronavirus Cyrus two, which is the new the new when we have that come out of war hand, China very topical now you're looking at, again, we don't really know because we don't know whether or not we are getting the accurate information. But some of my, some of the people that are coming out of China and talking, you know, you hear that it is very serious.

    Speaker: Thomas Kouo (35:22):

    It's not like they're, it's not a joke. They're saying that the Chinese government is reacting very well is like they're, they're very organized about it. They're, you know, it's not like just everybody's dying or anything like that, that there of course there are, there are and there, there are people are very sick and which happens at any of these kind of plague situations. But if we look at things, I like these kinds of things, we're looking at something where it doesn't matter how strong you are, you know, you can be, the optimal you can be often will strengthen and we call that pesto and sway lead sheet, which means that you're going to get sick anyway, right? And so the, the idea of the best, best defense is not there, you know, as is, as athletes. Like if you can prevent it then by, by not exposing yourself then, then that's the way to not get sick.

    Speaker: Thomas Kouo (36:11):

    But, but if you if you're exposed and essentially the pestilence, the pestle and ideas that they're there, the defense doesn't matter, right? So that that's where China's mess and had to sort of evolve because it was a very simple equation. You're stronger than that. You're fine. So we just make you stronger. Right. And then they found with the plagues that didn't matter. And so, so then they had to acknowledge and figure out, well okay it's G exactly. So yeah, exactly. Which is treat the symptoms, figure out how to reduce, reduce the pestilence to a point which the body could essentially then deal with it and push it out to the degree that it could. Yeah. Cause I loved the, I loved the concept coming from the Neijing wonder. One of the, one of the big lessons we get from that is, is that they say that the natural state is the healthy state, right?

    Speaker: Thomas Kouo (37:03):

    The natural state as a healthy state. If that, if that's true. Well, first of all, that reframes our jobs as acupuncture herbalists, right? Because if the natural state is the healthy state, then the kind of paternalistic way, and I don't mean that in a in a derogatory way, but the paternalistic methodology or way in which Western medicine treats is not the actual way that Chinese medicine actually should approach medicine, which would cause if the natural state is a healthy state, then we just need to get rid of the obstacle and get out of the way. And that's a whole different job description, right? Yeah. Because Western medicine in a very good way and you know, saved my life many times and most of us will just, I fix you. Right. And does that very well. And, and the question gets a debate is, is, is that, is that the best way to be your first first line of defense?

    Speaker: Thomas Kouo (37:59):

    Maybe. Right. And so because, you know, we, we all need that, you know, at some point, you know, and that has to be an option. So the question, yeah, so the question in terms of immune system immunology is a what it seems like I think, you know, we're preaching the choir with and with us, but, but it seems like the least intervention the better, right? Because if everything is about education to our, to our buyers, we teach our bodies how to be sick, we teach our bodies how to be healthy. And the more that we just kind of take over and just like, you know, use outside interventions, the, the less we educate our bodies. Right? And so the, I feel like in a way [inaudible], and I don't know if this is a fair statement, but I'll just say and see what is that we sort of, each time we do that we dumbed down our body somewhat, but we don't give it the opportunity to grow and evolve and change and learn. And, and that, that's sort of what, that, that idea of Western medicine is with all the cells that have that react to that and learn from it. Right? Because they have to have that kind of idea in Western mass. And we don't have that in Chinese medicine. And yet the approach in Chinese medicine is more geared towards that education of the body. Whereas sort of sort of,

    Speaker: Thomas Kouo (39:17):

    I completely agree and I think you can see that dynamic at play in antibiotics and sort of the abuse of antibiotics. So they have their, you know, I think most Western medical physicians and scientists would say like there is a true epidemic, true issue in our culture of over prescribing of antibiotics. And the repercussions of that is just what you said, which is that you're not letting a person's system, a person's body physiology actually deal with it on its own. And so you are dumbing things down and you actually become conversely more vulnerable ultimately to future sort of infections. And I think that that's actually a concept that's embraced now by Western medicine as well as Chinese medicine. And I think like integratively then bringing it back to sort of that, you know, sort of like what, what is sort of an integrative concept. I completely agree with what you said, which is there is a place and time for what Western medicine is particularly good at.

    Speaker: Thomas Kouo (40:16):

    Like if you're in a car accident and your bone is sticking out of your arm, please get me to a hospital and do not take me to an acupuncture or an herbalist. You know, and you know, that's an extreme example, but it's like certainly there's times time and place for Western medicine and what it does really, really well, which is, you know, first stayed in a 10th, you know, acute symptomatology. But if you're looking to ultimately strengthen a person so that they're less likely to ultimately get sick, that they're stronger than whatever, you know, sort of the pathogen is that's trying to sort of get in. I think that's what acupuncture does quite well. And I think ultimately from an integrated standpoint, they work quite well together. And part of integrative medicine is just an integrative practice ultimately is learning like what are the strengths and weaknesses of different modalities and, and when, when should they be brought to bear in a clinically?

    Speaker: Thomas Kouo (41:09):

    Yeah. You know, I'm actually really excited to, to work with some of the students here at Virginia. One of the things I w I want to that I don't know, and I, and I, I really want to hear what people have to say is that in innovative medicine we sort of, you know, we, we bring everything together, which I think is a really good thing because the more perspectives we have, the more ways in which we approach something, the more chance we have to be able to be successful. And yet when we look at our, our medicines, you know, we, we as Chinese medical practitioners, acupuncturist, herbalists, we look at our medicine and we have to decide, do we believe it? Do we, do we think it's right? Because especially with Chinese medicine where we're dealing with a physiology that we know scientifically is wrong, right?

    Speaker: Thomas Kouo (41:54):

    In many ways. Because you know, they've, it's amazing how, how much they got right, but there's still so much that is, that is wrong. And we have to look at, we have to say, well, Western medicine follow science. They have the cadavers, they have, you know, all these, the microscopes and then the, the scientific study that, that tells us that these things are right. And yet we have to look at Western medicine and Chinese medicine and say in the integrative, bringing it together, are they both right? Can they be both right? And if not, who's wrong? Right. And that's really an interesting thing to me. And you brought up antibiotics and, and this is why I wanted to, why I started thinking about this, because antibiotics, I think you're right, it is really interesting are the way that antibiotics have changed us. And if we look at antibiotics, antibiotics, again, we don't have, you know, antibiotics wasn't, you know, part of the material medical or you know, so, so, so we, we can just look at how it affects the body and kind of look at, let's say from a property standpoint, what, how would we categorize it because of how the body changes in relationship to that.

    Speaker: Thomas Kouo (43:05):

    So we look at high fevers and infections, which are our heat type of thing, a farro type type of you know, a of of phenomena. Then we would say that a antibiotic which is able to bring those scenes down, it would have to be cold, right? And so we would say, okay, yeah, so we say it's cold. It has, you know, antibiotic or antibiotic qualities or certainly the Western medical antibiotics are very cold. And then we would look and we say, well, generally speaking, how does it work? Will it, it sorta drains it downward. And so we would say that's bitter and colder, not like coppice like you said. So it was bitter and cold. Now we're looking at our external contractions from, from a from a Chinese medical perspective, a tie on tie on or or way level type of attack.

    Speaker: Thomas Kouo (43:55):

    Now in, in our medicine we say that the way that we take care of that is through diaphoresis or for the sweating it back out through the exterior. Right. And we do that because it's, it's still on the exterior. So the closest way to get it out is the closest door, which is out here. Instead of dragging it all the way through the body and then maybe out through the stool or anything. And then you know, you have this toxin that's going to affect the entire body as it on its way out. Right? So we want to get it out here and yet with the antibiotics, you know, because we look and we say, well a lot of the colds and flus that antibiotics are being prescribed for are what we entice them as would call exterior engagements, right? So exterior invasions, and yet we'd be using cold and bitter antibiotics.

    Speaker: Thomas Kouo (44:35):

    You're looking at now, now again, you're looking at a total change of the pathogen. So you have our wind heat, in this case, the, the, the heat aspect of that will be totally obliterated from the cold antibiotics. So your symptomology gone, fever gone. So, so you feel better. Absolutely. But the question becomes now, okay, well, unless it's extremely, extremely bitter, will it actually reached the thief, the anus stool to get out, right? Because you have a lot of space to travel in children. For example, pediatrics would be part of my practice. We actually, we actually cause bowel movement. We don't sweat a child cause their units too, too fragile. So we actually, we caused them to poop instead because again, the distance from the exterior to the Annison not very far in a child. So we can do that. But in an adult there's so much distance that the amount of bitter that you would have to have would be too damaging to the spleen.

    Speaker: Thomas Kouo (45:31):

    You kill it basically. So because of that, with the antibiotics you take, you deactivate, whatever that antigen virus, bacteria is, but then you draw it into the body, but you don't draw all that. You don't have enough to drive out of the body. So what happens is, is that if we're going, we're on the exterior and we're trying to drive down. So we say, okay, we'll dry down just down. It would be maybe somewhere here and then they're like pelvic girdle perhaps. And we know that the pelvic girdle is sort of, we w we think that the anatomy, it's sort of like we have the two kidneys, right? And then maybe in the middle you have the, the man fire, right? So you have the fire here, which is a physiological fire and, and doesn't burn in. So it's not exactly like fire, but it's a very important, still has a lot of fire properties.

    Speaker: Thomas Kouo (46:19):

    But when you drag it down, you know there is a way to, because of below that is, cause we say kidney is a call, right? But how's it call when the kitties are hearing the fires right here, right? Well because below it, the fires above it. So you got the installation here but still cold down here. So if you drag it down and it goes into that space, you're not quite enough to get out. But these, these inactive pathogens go down into that space. Well, you're okay now because, because yeah, because there's nothing there. There's no heat, there's nothing. Right. So it's basically dead crap in there. Just kind of cluttering up that that space below the issue is this, is that when you become really, really debilitated, because you already have, you have kidney fire, you have heart fire, my, the balance, right? So there's a balance between the two.

    Speaker: Thomas Kouo (47:09):

    Now if the kidney fire me, men wanes, if we have like if you become really sick, we know that well how, what, what's going on when you're really, really debility well the man starts to to like go down, right? If it does well then physiologically it's so important that what happens is that heart fire starts to assist it, right? Because the purpose, one of the, one of the purposes of that movement fire is to burn up into the cavity, keep to keep young the warmth in the, in the County. So if that's waning, then now you have the heart fire again, fire burn up. But, but these two fires are not physiological fires. So we know that if you take a match and you, you put up, did you just go burn her hand? Cause it's still gonna burn upward. But the heart fire has the ability, which is why it's not really a fire to burn back down into the cavity to help this if this is right, which it does.

    Speaker: Thomas Kouo (47:59):

    That's interesting because if it burns downward, might it reach that space down there, right? Because, because obviously if you're burning opera from here, you can't reach that ever. Right. But if you're burning down from here, if it's strong enough and you actually reach that, that stuff, that crap that's down there, excuse me, that that stuff that's down there becomes Kindle. And if you, if you heat it up again now you have years and years and years, antibiotics after antibiotics, antibiotics, antibiotics, that junk that's down there. If it later you've got a forest fire we see in California right there. And if that happens, now all of a sudden we have these really crazy reactions to just the exterior invasion. A cold, right? I don't or I'm really weak. For example, like I had a friend of mine who was a young lady and she developed SysMat, she lupus and otherwise when I first knew her, she's totally healthy.

    Speaker: Thomas Kouo (48:55):

    She got if she got seemed like a flu or a cold or flu and then just just went downhill from there and then all of a sudden she had lupus and went through all that symptomology and, and you know the, the, the typical things we see there. And if we look at at that, if the body was debilitated enough that burns down and it happened to light that Kindle and then we have a humongous reaction that comes out of nowhere. Say, where did that come from? I thought I just had a cold. Well that reaction again is another way to say perhaps auto-immune. Yeah. It's interesting because [inaudible] and yet we can say, well why doesn't everybody get it if you just weaken? Well, because it may or may not reach down there. Some people it will, if your heart fire strong enough, it'll reach down below that where the main man is to lie that if it's not, it won't.

    Speaker: Thomas Kouo (49:47):

    And if it doesn't, then then just still have jumped out there. Right. But if ever gets to that point where the heart fire has to be strong enough because the kidney fire is so weak and it actually reaches that down there and you do have stuff down there enough, then perhaps that's where these humongous reactions come because we realize all these pathogens that are just deactivated down there. So, so again, we have a kind of these different ways to understand autoimmune disease. And what's interesting is this one of the big symptoms of a lot about, I mean not everyone but is, is pain, right? So you seen pain particularly I think of like muscles, tenants and use that thing, right? So, so if we look at pain of the muscles or the muscular structure of the body as a big symptom of autoimmune disease, then we think, well, where's that pain?

    Speaker: Thomas Kouo (50:43):

    Where is that pain coming from, from a, from a, from a jingle from a acupuncture channel perspective, we're looking at what we call the TM attender. Muscular attended on muscular meridians, right? Now what's interesting is what flows in the tender muscular meridians is we cheat. So we choose is what flows in there. And we, we know that like in the primary channel, we have chia blood right in the blood blood right in there, in the TMMS we cheat is what actually flows in there. So that it's, it's interesting because if you look at TMMS what they're used for, we, we of course they're used for skull musculoskeletal problems, but they're also used for insomnia. They're also used for immunity, right? To boost immunity. And you would think, well what, what does the TMM have to do with immunity? Right? Except for the fact that we understand that weight, she flows through that.

    Speaker: Thomas Kouo (51:36):

    And if you think about that, that's the last line of defense, right? Because it's through the muscles once get past the muscles, you're in the interior of the body, right? And now, now as a whole different ballgame, right? So, so if we think about that, it's just again, looking at, at that idea of from an acupunc cause from an acupuncturist like we, how do we really treat immunity as acupunc cause we treat the Marines, we, we, a lot of times our TCM, we think about like Donald food's stuff in the interior, but we're not like, we're not going to needle the lung. Definitely not, right. Definitely not going to needle the hardwood if not, then need a kidney. So, so we have to access it through the meridians, right? That we, we, we suppose that the Sheehan blood flows through the meridians and through the which go to the organs and can affect the organs because a, as the chief flows through it, it is, it is the gas of the car.

    Speaker: Thomas Kouo (52:29):

    And so and yet it is the way she, of the TMMS that are going to be so important as it relates to immunity. And then putting that and thinking about like, you know, being healthy from an exercise perspective. Why? Cause I'll, I'll tell you what, like for myself, if I'm getting a cold, the first thing I do, I go to the gym, I go to the gym and I sweat it out, right? And, and, and I used to wonder like, why is that? Well cause I'm sweating and I'm pushing the pathogen out and now I realize, but when I go to the gym and I'm sick, I usually don't sweat. Like that's one of the things, I guess like the clouds at the exterior, I don't really sweat that much. Like if otherwise I swallow the hog, you know? But if I a butter, but essentially we, we are, we are like pumping the TMMS because we're pumping the muscles.

    Speaker: Thomas Kouo (53:18):

    So those meridians pass through the muscles. So what are we doing? We're actually fortifying the wheat. She was pushing the weight, she circulating it, creating a stronger defense, right? And so if we think about immunity from that perspective, again, we bring in that holistic view of why it's not simply just eat well, sleep well, take your vitamins and then, you know, it'll fight against that. But that lifestyle things that are so important. Chinese medicine, which you know, all our, all our practitioners and patients are always, you know, touting like good lifestyle, which is very important. But why is it important? Right? That's the thing is and being able to understand because that might help us to say like, okay, you should do Chico. Okay, yes you should. But first of all, what, you know, like what specifically is she long in general? Yes. But but form.

    Speaker: Thomas Kouo (54:14):

    Exactly right. And so, so I think that that's, it's just gives us a, it gives us a better understanding of how really to focus cause that's where I think the minutia is in Chinese medicine is in the understanding of what is actually happening and what you are actually doing. Thereby the points you choose, the herbal formulas you choose, the exercise or the, the lifestyle advice that you give is very specific for what we are trying to accomplish. And again, you know, we, we have a lot of these generic things that we do, which are all great, but whether or not that is going to be, you know, that is going to be the most efficient way to get to what we need to get done is the question. I think the more we understand, so the question is this with, with the, with the toy for that, but, but the idea of right or wrong is Western medicines approach to viral flus, bacterial, viral colds come out or is incorrect, is a correct, like they don't, they don't really do auto antibiotics anymore, right?

    Speaker: Thomas Kouo (55:22):

    They sorta figure that out. But we have Tamiflu, we have all this kinds of way. We don't really know what that is yet. But like could we, could we say that the approach back then with the antibiotics, were they wrong? Right. Cause it's hard. It's hard to make those kinds of statements because you know there's a very, exactly. And it's, you know, and again we were not trying to disparage anybody but, but can we actually say Chinese medicine in this sense is right and biomedicine just for this particular cause is wrong when we again in integrated medicine approach of Western medicine. Exactly. So, so in that sense, integrated medicine then becomes about a picking and choosing of what is right. Again, now you can have two things that are right, but I would probably argue in this particular case that we have a clear thing and would one was wrong. Now China has a wrong all the time. Well now I will tell a lot, right? So I'm not saying, Oh China dolls, right? But in this particular case, you know, just this example, we see that a medicine can actually be wrong. And so if that's the case, that integrated medicine and the way we approach integrated medicine has to be, has to be with the knowledge of knowing what we're bringing into it. Yeah.

    Speaker: Thomas Kouo (56:34):

    And I think ultimately that's the, and that is the future of integrative medicine is being able to know their relative strengths and weaknesses of the different modalities and how they can integrate and and work together essentially for clinical outcomes. And well, so interesting Thomas, and it's really clear that, you know, it's why you are the professor this week. I'm here at VU, I am teaching immunology. Your understanding of Chinese medical sort of physiology is quite, quite incredible.

    Speaker: Thomas Kouo (57:07):

    Well, I'll tell you what I, the, the thing about it is, is that especially with immunology, the one of the first things you have to say is that I don't really know anything because, because we know very, we have very basic statements and the rest of it we just have to sort of, we have to guess. And we have to, we have to say like, here's a, here's a, here's an idea. You know, and I'm looking forward to two people saying I don't agree with that because, because, and tell me why. Because then that might lead us to, to something that maybe you're right. You know, you don't know. I just, I don't, I don't know, you know, and there is no, no way for us to say yes or no. And so just like Western medicine and scientific studies that are consistently trying to validate things, trying to figure out are they right?

    Speaker: Thomas Kouo (57:55):

    Is this approach right? Chinese medicine has been around for thousands of years. We still don't know, you know, and, and and I think Western medicine is a, is a godsend in this particular way because it allows us to use a different paradigm to, to essentially hold it up to that lens and say, Hey, it, is there a way to validate this? Is there a way to look at this and say you know, here's a correlation that, you know, Hey, that's been validated. Here's something that works. A similar maybe that that's a, you know, that brings some validation here and, and, and it brings us additional perspective, which is, which is cool, but that's what this whole thing is that this weekend is about, is that, you know, if I would be very clear on day one, minute one, that I just don't really know much here. And it's really going to be a discussion that we can kind of hopefully have together and, and let's kind of,

    Speaker: Jeff Millison (58:42):

    Well, I think it's raising, it's raising, you know, greater awareness of, of Chinese medicine. It's approached, you know, obviously we don't in Western medicine or Chinese medicine don't have all the answers, but the level of scholarship that you're bringing to this is quite impressive. So thank you so much for being here today. It was wonderful having a dialogue about this very interesting topic. And thank you very much.

    Speaker 1 (59:08):

    Thanks for listening to all things integrated. Be sure to tune into our next episode where we'll share more information on how integrative medicine can help you lead a happier, healthier life.

     

    Topics: Podcast