THE PULSE · NO. 7
Tuesday 27 October. Open Sky, Mullumbimby.
Hot, humid and muggy, the air still electric after the thunderstorms.
Community clinic, Open Sky, Mullumbimby
I said it four times on Tuesday, in slightly different words each time, which is usually a sign the day is trying to tell me something. You can’t absorb what you can’t digest.
The first was a convalescence after surgery. The inputs were impeccable: good food, well-chosen supplements, rest. Nothing was landing. The second was an appetite that had gone quiet, breakfast taken as a duty. The third was the most instructive: years of an unpredictable gut, a diagnosis of SIBO (small intestinal bacterial overgrowth), a rigorous clearing protocol, genuine relief, and then the slow, demoralising return. On the bad days, a fog that settles over thinking itself.
That third arc is common enough to be almost archetypal, and it rewards close attention. It says something about nourishment that reaches well past the gut.
Population and terrain
SIBO tends to be framed as an infection, and the framing invites a war. A more accurate picture is ecological. The small bowel is meant to be sparsely populated; the dense microbial cities belong further down, in the colon. Overgrowth is less a matter of hostile organisms than of familiar ones living where the architecture was never designed to hold them.
What normally keeps them in their place is largely mechanical. Gastric acid and bile thin the traffic on the way in, and the ileocaecal valve keeps the colon’s residents from drifting back upstream. Most important is the migrating motor complex: a cyclical pattern of fasting-state motility whose strongest phase sweeps the length of the small intestine roughly every ninety minutes to two hours, clearing residue and bacteria downstream. It runs only when the gut is empty. A meal switches it off. A day of grazing barely lets it run at all.
This goes a long way to explaining the relapse. Antimicrobials reduce the population. They don’t, by themselves, restore the sweep. One frequently cited cohort found that close to half of patients had relapsed within nine months of antibiotic treatment. Mark Pimentel’s group has proposed that a past bout of gastroenteritis can leave an autoimmune footprint on the nerve cells that pace this motility. That hypothesis is promising rather than settled, but the direction of thought is right. Treat the population and leave the terrain as it was, and the terrain will, quite reasonably, repopulate.
Then there’s the fog. Roughly four in five fibres of the vagus nerve are afferent, carrying signal from the viscera up to the brain rather than the reverse. The gut also has its own nervous system of several hundred million neurons, a second brain in more than metaphor. When the bowel is inflamed, the brain hears about it continuously, through nerves and through inflammatory messengers. Cognitive clouding during a flare is less a strange side effect than the brain faithfully reporting the state of the body it lives in.
Intake is not nourishment. Accumulation is not abundance.
The official who receives
The Suwen describes the organs as officials in a court. The small intestine is the official charged with receiving and holding, from whom the transformation of things proceeds. Its signature function is separating the clear from the turbid: deciding what can be taken in and built into the body, and what must keep moving on and out.
That’s precisely the function that falters when things accumulate where they don’t belong. So on Tuesday I wasn’t trying to kill anything. I was attending to separation and to movement. A point at the elbow that cools the Yang Ming, the channels of the stomach and large intestine. A pairing at the wrist and hand. And the lower command points of the two intestines, below the knee, whose names translate as the Upper and Lower Great Void.
I’m fond of the fact that the intestines’ command points are named for hollowness. The physiology agrees: the housekeeping happens in the gaps. I suspect the same is true of a life.
In five-phase theory the small intestine is paired with the Heart, both belonging to Fire. The Heart is sovereign, the seat of shen, the luminous awareness that gives a life its orientation. The small intestine is its minister of discernment, sorting what belongs from what doesn’t. One discriminates in matter, the other in meaning. So when the man on the table said that he feels most himself when he has a mission, I heard the pairing speak. Purpose isn’t separate from digestion. It’s what tells the whole system what to keep.
Digestion as a theory of mind
The classical texts locate yi, the faculty of thought and intention, in the Spleen, the organ system that governs transformation as a whole. They also say that excessive pensiveness injures the Spleen. English preserves the same intuition in the word rumination, borrowed from the animal that chews its cud. Thought that cycles without resolving is the mind chewing something it can’t swallow.
The psychoanalyst Wilfred Bion built an entire theory of thinking on this metaphor. Raw, unprocessed experience, which he called beta elements, must be metabolised by what he named alpha function before it can become usable thought, memory or dream. What can’t be metabolised is either evacuated or remains lodged, undigested, in body and behaviour. Chinese medicine would recognise the structure immediately. Experience that isn’t broken down and sorted doesn’t disappear. It stagnates, and stagnation, given warmth and time, ferments.
I’m wary of collapsing this into a claim that gut trouble is hidden emotional trouble. That’s too tidy, and it quietly blames people for their biology. The more interesting position is that the gut and the mind run on a shared logic, and each can teach us about the other. Intake is not nourishment. Accumulation is not abundance. What converts one into the other is the capacity to break down, discriminate and release.
Kindling before logs
Chinese medicine has a terse clinical maxim for the convalescent on Tuesday: xu bu shou bu, the deficient cannot receive tonification. Pile rich, nourishing substances onto a weakened digestive fire and they sit there undigested, adding to the burden they were meant to relieve. The sequence matters. Restore transformation first, then nourish. You don’t heap logs onto embers. You give them air and kindling, and wait for the fire to catch.
The practical corollaries are modest and they compound. Leave genuine intervals between meals so the motor complex gets its turn. Favour warm, cooked food and room-temperature drinks over iced ones. A few minutes of brisk movement before breakfast, and a little ginger or cardamom, help the fire catch. Eat seated, slowly, with your attention on the food rather than a screen.
What would change if you measured a week by what you actually metabolised, rather than by what you took in?
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Related reading: Which way is up · The cough that hangs around · Chapter Gate · Get Your Feet Off the Cold Floor
Community clinic, Tuesdays and Thursdays. Open Sky, Mullumbimby.
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