The Nighttime Hours
The current 24 hour cycle that has been regarded as fact in the teaching of Traditional Chinese Medical (TCM) theory is due a reconsideration. With the advancements of modern science we are able to start a discussion regarding a consideration of a different approach to a chronological time wheel from a number of different angles. I propose that we begin by associating the time segments relative to physiological function throughout the day. In my clinical practice, I have noticed some discrepancy between client's descriptions of symptoms, and how the traditional 24 hour clock is arranged. I have done my best here in this article to reconsider the hourly order, based on observation, functional biology, and general physiology.
The discussion that I will open the door to with this article may continue on, and I welcome anyone to test the efficacy of these assertions through observation and clinical practice, especially with regard to diagnostic application through reference to the Tan Cycle and the Yu Angles. (Keane) More detailed information about these specific treatment theories, can be found in the book 'The Tao of the Polyvagal Theory: A Five Element Perspective for a Future of Healing the Spirit and Balancing the Autonomic Nervous System.' (Id.) These treatment theories are informed by research of the Autonomic Nervous System (ANS) from a functional perspective, observations and research within my clinical practice in visceral and neural manual therapy, and the ground breaking work of neurobiologist Dr. Stephen Porges, and clinician Deb Dana, relative to The Polyvagal Theory. (Porges)
The reorganization that I am presenting with this article, I call The Tan Cycle 12 hour Clock, in order to distinguish it from the traditional organ affiliation clock that has been widely regarded as fact since the details of TCM theory were brought to the Western world in the 1940s and 50s by the Mao administration.
In my clinical practice, I have noticed the time frame associated with the liver has almost always held true, and that clients who routinely wake up with agitation or discomfort around the 3:00 am hour, have liver restrictions that possibly are referring into their ANS through vagal afferent connections, relaying information from the viscera into the vagal nuclei in the brainstem, potentially causing a surge of norephinephrine from the locus coeruleus, or possibly creating some sympathetic activation from anastomoses with the Phrenic nerve, as the Phrenic nerve is the sensory nerve of the gallbladder, as well as the motor nerve for the diaphragm. The liver is attached to the diaphragm through a dense ligament called the coronal ligament. This ligament is a double fold of peritoneum, running nearly the entire length of the diapragm, from anterior, circling around the top of the liver, to posterior.
Moreover, physical restrictions in the biliary area could be causing restlessness during this period while one is usually asleep, as the liver is physiologically active during these hours. During the night, as we rest, the liver must create glucose for our cells, as our blood sugar drops while fasting; this is the process of glucogenesis. The liver is also involved in lypolysis and fatty acid oxidation. (Aviram, et al.)
Because the liver and the gallbladder are so intricately linked, both in neurology, physiology, as well as in function, through the digestive process of output of bile, I propose merging the time between midnight and 4:00 am to include both the gallbladder and liver. As a matter of fact, the energetic quality of the sleeping hours are also characteristic of blurred lines and energy weaving into and out of shape and form. Thus, it seems fitting from an aesthetic point of view to combine these two organs into a relative space where one merges with the other, without boundary.
Merging the hours of the pericardium and the heart into one time block seems fitting as well, as the main function of the pericardium is to suspend and protect the heart. The previous article I wrote in favor of reorganizing the Fire Element, is supportive of the yin/yang pairing of the heart and pericardium, respectively, by reason of theoretical physiology, based on science and anatomical reference.
Working backward, from the midnight hour, I propose the heart and pericardium time to be between the hours of 8:00 pm and midnight. This is the time of day when the energy of the organism draws inward, after daylight fades, into rest. This is also the time of day when the energy of the heart is of paramount importance, and in cases of chronic heart disease, this is the time where a person may wake up with shortness of breath, as the heart is not able to fulfill its functions, letting out a cry for help to the ANS, and shifting the body into a stress response. And in cases where one has something that is “heavy on their heart,” for example: some stress of daily life, or an emotional experience that is occupying their mind, they may not be able to settle into a restful state of being. This can lead to late nights and an inability to fall asleep. Also, research has been shown that people that go to sleep before the 11:00 pm hour, and wake before the 8:00 am hour, have a statistically significant decreased risk of congestive heart failure. (Yan, et al.)
These findings regarding decreased risk of congestive heart failure, suggest also that drawing inward and falling asleep before 11:00 pm, as well as waking before 8:00 am to be beneficial to the heart's function and resilience. Theoretically, the benefit of waking before 8:00 am could be a result of a functioning and balanced kidney and adrenal energy. With a functioning and balanced hypothalamus, pituitary, and adrenal (HPA) axis, serum cortisol levels rise in the morning hours, initiating the process of waking, though activation and elevation of the heart rate and blood pressure. (Scheving) This would also coincide with the kidney and adrenal glands being supportive energy for the heart, through associations illustrated within the Yu Angles treatment theory, referenced previously in this article. (Keane)
Let's now move our attention back to the morning, and propose the time between 4:00 am and 6:00 am as being relative to the bladder, with the time of 6:00 am to 8:00 am as being relative to the kidney and adrenal. (Cortisol, Cleveland Clinic) Physiologically, the energy of the bladder starts to rise as urine fills overnight, and often people wake to urinate between the hours or 4:00 am and 6:00 am, if they have had too much to drink before bed, or potentially have visceral restrictions in the bladder that limit the storage capacity in some way. Moreover, of course the natural circadian rhythm in balance rises serum cortisol levels in the morning, for us to wake with the rising of the Sun, between 6:00 am and 8:00am.
This covers the 12 hour nighttime portion of The Tan Cycle 24 hour Clock. Of course, there is much more discussion on the merits of these placements that I could go into, but for the sake of brevity in this article, I will keep this analysis simple. I will elaborate on the proposed evolution of the daytime 12 hour segment, in the next article. Please leave a comment on your thoughts regarding this assessment, or any clinical observations you would like to share.
References
Bin Yan, Ruohan Li, Jiamei Li, Xuting Jin, Fan Gao, Ya Gao, Jiajia Ren, Jingning Zhang, Xiaochuang Wang, and Gang Wang. Sleep Timing May Predict Congestive Heart Failure: A Community‐Based Cohort Study. Originally published 5 Mar 2021https://doi.org/10.1161/JAHA.120.018385Journal of the American Heart Association. 2021;10:e018385 https://www.ahajournals.org/doi/10.1161/JAHA.120.018385
Rona Aviram, Gal Manella, Gad Asher, The liver by day and by night, Journal of Hepatology, Volume 74, Issue 5, 2021, Pages 1240-1242, ISSN 0168-8278, https://doi.org/10.1016/j.jhep.2021.01.011.
Scheving LA. Biological clocks and the digestive system. Gastroenterology. 2000 Aug;119(2):536-49. doi: 10.1053/gast.2000.9305. PMID: 10930389.
Cortisol: What it is, function, symptoms & levels. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/22187-cortisol#:~:text=For%20most%20tests%20that%20measure,3%20to%2010%20mcg%2FdL. Accessed March 1, 2023.
Keane, Nicole Rachelle. The Tao of the Polyvagal Theory: A Five Element Perspective for a Future of Healing the Spirit and Balancing the Autonomic Nervous System. Gratitude Healing Arts, LLC; 2021
Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. W W Norton & Co.
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