Chinese medicine may be considered to possess an ecopsychosocial view. Here, the internal and external ecology blend with the psychological and spiritual well-being of the individual and their social systems.¹ We stand at a crossroads of: meteorology, biology, psychology, and sociology.

This is not merely a transdisciplinary zone. It is a mode of being and thought which transcends temporal bias; whereby, we are actively engaged in synthesizing premodern with contemporary thought.

We must ask the question, is ecopsychosocial medicine integrative medicine? Possibly, but there are problems with the word "Integration." It has been used as a tool for colonization, whereby the colonized lose their identity in the context of being integrated. Integration takes place throughout strata of social contexts and include individual clinics, larger organizations, municipalities, state, regional, national and international policy zones. Practitioners may also co-opt procedures of other disciplines and paradigms of thought are often mixed.²

Integral Features

The ecopsychosocial view of medicine has integral features. In this vision, practitioners sustain the identity and integrity of their discipline through language, modes of thought, supplies, knowledge transmission and professional judgment. While there are collaborative and cooperative processes amongst the disciplines, who we are - as a voice in the world - sustains. Emerging from a clear sense of historical, contemporary and cognitive presence, practitioners of Chinese medicine are in a position to engage with emergent scientific views in ways that are meaningful.

The microbiome is a significant piece of current medical discourse. It is a term coined by Joshua Lederberg in 2001, that links to functional medical thought, integrative medicine and ultimately, an eco-psychosocial view. He defines it as, "the ecological community of commensal, symbiotic and pathogenic microorganisms that literally share our body space."^3,4 The term micro biome, or microbiota, has been used loosely throughout scientific literature to describe both internal and external ecologies. The human microbiota consists of the 10-100 trillion symbiotic microbial cells harbored by each person, primarily bacteria in the gut; the human microbiome consists of the genes these cells harbor.⁵ Microbiome projects worldwide have been launched with the goal of understanding the roles that these symbionts play and their impacts on human health.

I recently presented at an American Herbal Guild conference in Danby, Colorado. Richard Mandelbraum, also presented a lecture entitled: The Macrobiome: It's Not Just the Microbiome that Matters! He defines the macrobiome as, "The broader ecological community (ecosystem) of micro – and macro – organisms that we belong to, the vigor and vitality of which has direct influence on our health as members of that community." While he is not the first to employ this term, which seems to be emerging in the early portion of 2014, he is the first to offer a distinct definition. While it is not a legal Scrabble term, the ideas are gaining good traction in the literature, and I believe should be considered as useful distinctions.

Good Gut Health

Integrative and functional medicine operate within the zone of ecopsychosocial medicine, and include the ecosystems of the gut or the "microbiome." We have seen the correlation of good gut health with a healthy psychological states.⁶ Individual mental health may be correlated with that of the planet when we consider the "Gaia principle" as a concept of Earth as a living being, and in this case, as it relates to the center of our experience of the macrobiome.⁷

There are two texts that could be classified as premodern sources for an in depth discussion of what is now being called the macro and micro biome, the Treatise on the Spleen and Stomach (Pí Wèi Lùn) and the Treatise on Cold Damage and Miscellaneous Diseases (Shang Han Za Bing Lun).⁸ It would appear that Li Dong Yuan and the Spleen Stomach School had it right in 1249 CE! Earth is the center. It is the center of the human experience in terms of food and nutrition, but also, the production of blood which gives us the vital life force to bring our spirit to action upon the world around us.

It could be argued that genetically modified organisms pose the largest risk to the macro and micro biome in the history of humanity. Jeffrey M. Smith, executive director of the Institute for Responsible states that, "Gluten sensitivity can range in severity from mild discomfort, such as gas and bloating, to celiac disease, a serious autoimmune condition that can, if undiagnosed, result in a 4-fold increase in death," and that, "Bt-toxin, glyphosate, and other components of GMOs, are linked to five conditions that may either initiate or exacerbate gluten-related disorders." Known harm associated with GMOs include damage to the intestinal wall leading to increased permeability, imbalanced gut bacteria, allergies, and impaired digestion. GMOs damage both the micro and the macro biome.

The macro-micro biome relationship could be viewed as another expression of Taoist philosophy. Consider the iterations of yin and yang, whereby they mutually oppose each other, define will each other, transform each other and consume or amplify each other. This set of relationships could be used to describe the interplay between the micro and macro biome. Hermetic philosophy is another point of view where, "True, without falsehood, certain and most true, that which is above is the same as that which is below, and that which is below is the same as that which is above, for the performance of miracles of the One Thing."

We described the problems and terms. One larger solution would be to ban GMOs. There must be serious consideration of the wide-scale damage or bizarre enhancement of evolutionary potential on this planet. The larger solution would of course be divesting of a corporatized government. "A few years ago, there were sixteen countries that had total or partial bans on GMOs. Now there are at least twenty-six, including Switzerland, Australia, Austria, China, India, France, Germany, Hungary, Luxembourg, Greece, Bulgaria, Poland, Italy, Mexico and Russia. Significant restrictions on GMOs exist in about sixty other countries," says Walden Bello.⁹

It would seem that some local solutions could be adopted immediately. We could refuse to purchase foods that are not labeled for GMO. While we could employ the digestive class of herbal agents, there are limitations. Problem? Gluten sensitivity. During the 80s and 90s, I was able to use this material much more freely in my clinical practice. As the presence of genetically modified organisms has increased in our environment, the amount of gluten sensitivity has virtually exploded in my practice. I can rarely use the herbal combination I received from my teacher, John HF Shen for treating digestive disorders: Take Massa Medicata Fermentata (shen q) for instance, Fructus Setariae germinatus (gu ya), and Fructus Hordei germinatus (mai ya).

Mushrooms are an excellent solution. In addition to transforming fluids, nourishing the immune system and boosting vitality, they serve as prebiotics for the micrbiome, augmenting the growth of beneficial bacteria such as Acidophilus and Bifidobacterium. Mushrooms like Reishi - Ganoderma lucidum (ling zhī) and Turkey Tail - coriolous diversicolor (yun zhi), not only boost the immune system, but also balance the microbiome in favor of these beneficial bacteria, resulting in better digestion, and potential weight loss.

Several concerns impinge upon the education of Chinese medicine in the United States of America. At the moment, there is very little dialogue about the contemporary problems of ecopsychosocial systems. Early literature of the Han dynasty C.E. 200 includes concepts of meteorological events, social awareness and personal conduct on a relatively large scale set of interrelations. Some programs explore these problems in detail, however few if any programs of East Asian medicine, Chinese medicine or acupuncture have coursework that focuses upon the the problems of GM on products in the food supply and in the ecosystems. Fewer yet have robust content on ecological concerns as they relate to the microbiome and microbiome. This is a call for the address of eco-psychosocial concerns based upon our contemporary problems as a moral obligation to professionals entering society.

References:

1. Morris WR. Chinese pulse diagnosis: Epistemology, practice, and tradition [dissertation]. United States, San Francisco, California: California Institute of Integral Studies; 2009.
2. Morris W. Is Chinese Medicine Integrative Medicine? American Acupuncturist. 2011;Vol. 12(09 ).
3. Ursell LK, Metcalf JL, Parfrey LW, Knight R. Defining the Human Microbiome. Nutr Rev. 2012;70(Suppl 1):S38-44.
4. Lederberg J. 'Ome Sweet 'Omics-- A Genealogical Treasury of Words 2001. Available from: http://www.the-scientist.com/?articles.view/articleNo/13313/title/-Ome-Sweet--Omics---A-Genealogical-Treasury-of-Words/.
5. Turnbaugh PJ, Ley RE, Hamady M, Fraser-Liggett C, Knight R, Gordon JI. The human microbiome project: exploring the microbial part of ourselves in a changing world. Nature. 2007;449(7164):804-10.
6. Foster JA, McVey Neufeld K-A. Gut–brain axis: how the microbiome influences anxiety and depression. Trends in Neurosciences. 2013;36(5):305-12.
7. Lovelock JSE. The Quest for Gaia. New Scientist. 6 Feb 1975;65(935):304.
8. Zhang Z. Shang Han Lun: On Cold Damage, Translation & Commentaries. Brookline, MA: Paradigm Publications 1999 200 CE.
9. Bello W. Twenty-Six Countries Ban GMOs—Why Won't the US?
10. The case against GMOs has strengthened steadily over the last few years, even as the industry has expanded all over the world. : The Nation and foreign Policy in Focus; 2013 [cited 2015 11/7]. Available from: http://www.thenation.com/article/twenty-six-countries-ban-gmos-why-wont-us/.

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