Gut Dysbiosis: Root and Branche

Ben/Biao is a method of diagnosis within Chinese medicine that translates into Root/Branch.

This method allows the physician to parse out which symptoms are branches of an underlying root cause. For example, if a woman presents with hot flashes, the symptom of hot flashes may be the branch of an underlying Kidney Yin Deficiency, which would be the root cause needing to be brought back into balance. While gut dysbiosis is a biomedical diagnosis, this condition can also be explored in a similar fashion.

    Gut dysbiosis is a hot topic in health these days as new frontiers in research science are beginning to reveal how intertwined our gut health is with our overall health. Indeed, new links are being made between gut dysbiosis and a wide array of chronic health issues such as obesity, diabetes mellitus, endometriosis, ulcerative colitis, anxiety, depression, ADHD, etc. (Sun and Chang, 2021). One quickly sees that these diagnoses of obesity, endometriosis, etc. are the branches of an underlying root issue of gut dysbiosis. The most basic symptoms of gut dysbiosis present clinically as nausea, bloating, flatulence, abdominal distension, abdominal cramping, abdominal pain, diarrhea, and/or constipation (Pimentel et al., 2020). The biomedical diagnosis of gut dysbiosis with this symptom presentation translates into a wide array of pattern diagnoses in Chinese medicine e.g. Liver Qi Invading the Spleen, Spleen Qi Xu, Liver Qi stagnation, damp heat, damp, yin fire, etc. (Maciocia C.Ac, 2015).

While these patterns may seem broad and numerous, Chinese physicians have specifically known for at least 2,000 years that a healthy gut microbiome is essential to good health as evidenced by Ge Hong treating food toxin diarrhea with the first recorded Fecal Microbiota Transplant (FMT) in the 4th century AD (Honggang & Xiaozhong, 2020). This was documented in his book Zhou Hou Bei Ji Fang Handbook of Prescriptions for Emergencies (Honggang & Xiaozhong, 2020).  Indeed, going back to the Huang Di Nei Jing Su Wen Chapter 61 written no earlier than the first century A.D. and translated by Unschuld (2003), the following was said:

[Huang] Di:

The spleen does not rule [a specific] season; how is that?

Qi Bo:

The spleen, that is the soil. It governs the center.

Throughout the four seasons it tends the four depots.

In each [season] it is entrusted with government for eighteen days;

it cannot rule an [entire] season by itself.

The spleen depot is permanently endowed with the essence of the stomach, [i.e., of] soil.

As for the soil,

by generating the myriad beings,

it takes heaven and earth as laws.

Hence,

in the upper and lower [parts of the body] it reaches head and feet;

it cannot rule a [specific] season by itself.341

First, it is important to note that the Chinese reference to Spleen and Stomach are not synonymous with the biomedical concepts of the physiological spleen and stomach (Wu, 1998). Rather, as Unschuld notes in his introduction, Chinese medicine is based on systems of correspondence e.g. yin and yang, five-phase theory, etc. (2003). One can see from this passage that the Spleen and Stomach are associated with soil, earth (Unschuld, 2003). More importantly, this passage states that the Spleen, corresponding to earth, holds or governs the center which one can extrapolate that the health of the Spleen is essential for the health of the whole organism (Li Dong-yuan's, 2004). This further demonstrates the central knowledge of Chinese physicians that good health is governed by good digestion, and one cannot have good digestion without a healthy microbiome (Umeda, 2019). This basic tenant of Chinese medicine continues to be validated by research science emerging from China and Taiwan, offering a unique perspective about gut dysbiosis as their research combines both biomedical and TCM approaches (Honggang & Xiaozhong, 2020).

      “The sages did not treat those already ill but treated those not yet ill. They did not govern what was already in disorder, but what was not yet in dis- order... Now, when drugs are employed for therapy only after a disease has become fully developed, when [attempts at] restoring order are initiated only after disorder has fully developed, this is as if a well were dug when one is thirsty, and as if weapons were cast when the fight is on. Would this not be too late too?” – Su Wen Ch 2

As the Su Wen indicates in the passage above, treating dysbiosis before disease manifestation is of utmost importance to prevent further health degradation from the persistence of dysbiosis.  The best cure for gut dysbiosis is prevention by minimizing environmental toxins as well as maintaining a healthy diet that incorporates probiotic foods such as live cultured yogurts, vegetable ferments, etc. There is no singular approach to curing gut dysbiosis once it has manifested. One must take a multipronged approach to treatment: diet, acupuncture, herbs, and minimizing and/or eliminating environmental/pharmaceutical toxins. While there are several diets that can help heal the gut, the basic idea is to not eat processed/fried foods, minimize and/or eliminate inflammatory foods such as nightshades, dairy, sugar, alcohol and caffeine. Acupuncture has been shown to be effective in the treatment of specific branch issues of gut dysbiosis such as obesity, endometriosis, anxiety, depression, etc. Herbs can also help bring the overall digestion back into proper homeostasis as can a good probiotic supplement as well. All of these modalities combined can help reverse the condition over time.

      There is the idea that the microcosm reflects the macrocosm and, as noted above, the Spleen ad Stomach are associated with the earth element in Chinese medicine.  As such, what is happening in the environment will happen to the human. An excellent example of this phenomenon is cold-damp during the winter environment resulting in swelling and pain in a knee joint.  Is it any wonder that a disharmonious earth element by way of digestive issues and other chronic diseases are ubiquitously observed in patients when we can look out our windows and see the effects of our earth at large being out of balance? This is simply yet another consideration as to why one may want to look deeper at this root issue of gut dysbiosis – perhaps by tending our own individual earth we may be able to help heal our collective earth.