Each of us, when in school or reading our various reference books, whether it be point location (Where the red and the white meet) or identifying certain patterns (red face/malar flush) was exposed to a glowing error in education and practice standards that continues to be repeated even in mainstream medicine. When we speak of the “4 Pillars of Diagnostics”, no single pillar is more important than another. Clearly, we lacked exposure to any but lighter skinned examples of disharmony in a majority of educational settings. I use the newer term melanated on purpose. This term, to me, expresses the wide range of skin tone variation and is the most medically relevant term available.

What is melanation/melanated? The word “melanated" refers to the presence of melanin in the skin, hair, or eyes. Melanin is a pigment produced by cells called melanocytes and is responsible for determining the color of skin, hair, and eyes. People with higher levels of melanin are often described as melanated. It is also a term that is now commonly used to celebrate people of black and brown skin tones.

What is melanation/melanated? The word “melanated" refers to the presence of melanin in the skin, hair, or eyes. Melanin is a pigment produced by cells called melanocytes and is responsible for determining the color of skin, hair, and eyes. People with higher levels of melanin are often described as melanated. It is also a term that is now commonly used to celebrate people of black and brown skin tones.

The medical understanding is important for both its positive and negative attributes. The positive role of melanin is many fold. It protects us from UV radiation. Melanin helps against free radicals and has antioxidant properties. It helps to regulate body temperature. It is also vital in wound healing as well as protecting the eye from sun damage.

There are also some downsides to larger amounts of melanin in our current society. Because of reducing the effects of the sun's UV radiation on the body, the melanated patient has to work harder to maintain healthy Vitamin D levels. Therefore, vitamin D should be tested as part of annual blood work. Also, we see that close to 80% of melanated patients lack the enzyme to properly digest dairy. Therefore, patients should be advised to avoid dairy to reduce overall inflammation and improve nutritional absorption.

But in a larger context when we look at people who have darker/more melanated skin, these people have suffered at the hands of the medical system through history, right up to at least the 1970’s. We also find many misconceptions in mainstream medicine: A questionnaire of new medical school graduates found frightening beliefs; Blacks’ nerve endings are less sensitive than Whites, Black people's blood coagulates more quickly than Whites, Whites are less susceptible to heart disease than Blacks, Blacks’ skin is thicker than Whites. In some cases, over 40% believed these misunderstandings. We can also see this in the rates prescriptions being written.

We are no different in the Acupuncture community. It is vital for each of us to rebuild that trust by demonstrating an understanding of the needs of the melanated community and improve our ability to recognize imbalances.

It is because of long standing mistrust of the medical community that we as a profession must make every effort to ensure that we are doing our best to provide the same quality of care, especially diagnostic care to all shades of human. 

Let me give an example; most pathology textbooks that we were taught, in the very first chapter, discussed inflammation. The basic indications of inflammation were taught to us from the Greeks. Inflammation is characterized by five primary signs, redness (Rubor), swelling (Tumour), heat (Calor), pain (Dolor), and loss of function (Functio Laesa). Unfortunately, this is not the correct color for melanated people.

In Chinese medicine, we look at red skin color to indicate excess or deficient heat. It is often associated with conditions such as heat syndromes, excess Yang/excess Fire or Yin deficiency. To recognize this pattern on the melanated patient we would look for darker skin on the whole face or just in the malar area under the eye. We can compare the color of the arm, chest, or sometimes the neck to the face color to get an accurate color palette for comparison that is correct for each individual.

As good providers of quality healthcare, we must ensure that we can recognize imbalances and disease in the diversity of people who need our care. We must not allow race and the mistakes of the past prevent us from improving our diagnostic skills to encompass everyone who desires and needs our unique skills. I hope you all can join me in Orlando, Florida this August to explore in great depth and detail this timely and needed discussion.

Robert Linde AP took a circuitous route to becoming an herbalist and acupuncture physician. His career changed many times; commercial lobster and conch diver, treasure hunter, sail and canoe instructor, wilderness youth counselor, long-line fisherman, an infantryman in Desert Storm, and GreenPeace worker. Now, Bob focuses as the owner of Acupuncture & Herbal Therapies in St. Petersburg Florida, and the director of Traditions School of Herbal Studies. He also consults as a product developer for herbal product companies for humans and animals and enjoys growing many medicinal herbs in his yard. Bob has presented at the FSOMA, Florida Herbal Conference, and the American Herbalist Guild conferences. He lectures regularly at colleges and organizations around the US. You can listen to his monthly Podcast; Mastering Herbalism with Bob Linde and his monthly Facebook event Herbalist Open Forum, an opportunity to pose real questions to Bob. You can see many of the past episodes and bioregional classes on the Traditions School of Herbal Studies YouTube page. Bob is also a traveler and travel writer. He has lived in Europe and traveled to the Amazon, Galapagos, Yukon Territory, the Caribbean, and throughout the US. Bob recently completed 12 episodes for INTI TV, “Sanaciones con Bob Linde”, an exploration of indigenous people’s herbal practices. He has also appeared on Animal Planet and many other TV shows.  Find out more at www.acuherbals.comand www.traditionsherbschool.com