Usually this column analyzes lab results. For this issue, we asked New York City acupuncturist Ann Brameier, LAc, a practitioner who treats many people with HIV, to evaluate the health of POZ founder Sean Strub from the perspective of Chinese medicine.

Sean’s pulses are thin, wiry and a bit floating, indicating a relative excess of yang that needs to be better rooted by yin. Excuse me? Ahhh…perhaps a bit of explanation is needed. Based on the Taoist philosophy of the fundamental duality of nature, Chinese medicine is a 4,000-year-old system that attempts to improve and maintain health by restoring harmony to the body, mind and spirit. This, in turn, allows the person to self-heal on all three of those levels. Acupuncture, herbs, acupressure, chi kung (a system of breathing and gentle exercise; see “Say Chi,” POZ, March 1998) and dietary therapy are all used in the healing process. Many PWAs have found that these approaches can complement their Western drug regimens, thus countering medication side effects, improving energy and relieving many symptoms.

The focus is on restoring balance between the opposing but complementary forces of yin and yang. While both are complex, a simple explanation is that yin represents the body’s anabolic or repair functions, as well as cooling energy, while yang symbolizes metabolism—the breakdown of food into energy—and “fiery” or aggressive energy. A healthy person is in balance between yin and yang, while someone in ill health has a relative deficiency or excess of one of these. Although each individual is different, many practitioners have observed that PWAs tend to have a relative excess of yang.

Thus, assessing yin and yang is the starting point for a Chinese medical diagnosis. In Sean’s case, as with all new patients, this began with a very complete history: Chief complaints (why he came to see me), secondary complaints, past health history and specifics about digestion, diet, respiratory function, sleep, energy, pain, emotional balance, work, exercise and habits. For a female patient, I would also ask about gynecological issues. The next step was doing an abdominal palpation and assessing muscle-tissue tightness or congestion. Accompanying this was a visual observation—checking the complexion, observing the general demeanor and doing a careful assessment of the tongue.

Finally, I took Sean’s pulses—yes, that’s meant to be plural: Chinese medicine holds that pulses at each of 12 sites (six on each wrist) can indicate the level of vital energy flowing from particular organs or areas of the body. And the overall feel of the pulses can shed light on systemic health. Placing three fingers on the radial artery at each wrist, I felt for Sean’s pulse qualities, and then checked the pulse at the site under each of the three fingers used. The wiriness of Sean’s pulses, somewhat like a guitar string, is a general indicator of some kind of tension. This type of pulse is often related to liver stagnation. Sean’s pulses were also a little fast, and slightly superficial or “floating”—meaning that they are easier to feel on the surface, near the skin.

Given Sean’s overall situation, this combination of floating and speediness suggests a relative excess of yang due to a  moderate deficiency of yin. This appears to be reflected in Sean’s tendency to wake up in the night, his night sweats (recently improved), his low-grade anxiety, and his dry mouth and skin—all typical of deficient yin.

These symptoms—and deficient yin itself—are often the product of a chronic disease process, overwork and continued use of medications, all of which Sean has experienced in recent years. Sean has also long suffered from esophageal reflux (acid backing up into the throat), which has been improved by the acid-inhibiting drug Prilosec. I consider this type of overacidity a form of excess yang. The Chinese approach to this would be to reduce heat with an appropriate herbal formula, perhaps the Left Metal Pill or the Ophiopogon Drink. Acupuncture might also help resolve this problem, as well as improving the mild, drug-induced neuropathy in Sean’s feet.

My initial acupuncture treatment for Sean was intended to begin to restore balance, particularly emphasizing the kidneys—considered the body’s source of yin and yang. I also strongly encouraged Sean to resume a regular regimen of nutrient supplements (see “Power Nutrients,” POZ, July 1998).

Overall, it appears that Sean has come back from severe illness to a point of much better balance. Chinese medicine might be able to consolidate this, and direct him toward even greater harmony and health.