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Sep 10, 2012

Effects of music and sound on human health

Herbalist Review, Issue 2002 #1: by Roger W. Wicke, Ph.D. Many people assume that music is just harmless background noise; yet modern scientific research confirms the opinion of ancient philosophers that music and sound may have profound effects, both harmful and beneficial, on the health of people and even plants. Page contents… Copyright ©2002 by RMH-Publications Trust; all rights reserved. Historical references to the health effects of music The use of music and sound to improve health is not a novel idea. Both harmful and beneficial effects of music have been recognized by the ancient Greeks and Romans, including Pythagoras, Democritus, Aristotle, Galen, and Celsus. [2b] Traditional Chinese medicine (TCM) refers to the qualities of specific instruments and sounds and their beneficial effects on various organs. Plato, Cicero, and Seneca all believed that music profoundly affected the behavior of entire societies and that the state should regulate the performance of music and prohibit certain types because of their potentially harmful effects. [2a] While such sentiments may be extreme, Plato's views remind us that the modern benign attitude toward music as mere "auditory cheesecake" [1a - 1c] contradicts the more ancient view of music as a powerful cultural force, for good or evil. According to many musicologists, music is a form of language or communication that directly accesses the emotions without the intermediation of words and rational thought. Oswald Spengler, in his history text "Decline of the West", devoted several chapters to the role of art and music in the stability of civilizations. [2c] He observed that musical traditions consistently reached their pinnacle of classical form and beauty before a civilization achieved its technical and political zenith, and that a general decline in artistic and musical forms augured its demise. He predicted that based on the popularity of extreme romanticism and excessive sentimentality, dissonance, and 12-tone compositional styles in music of the early 20th century Europe, Western civilization was fated to decline, even as its technical and scientific wizardry promised great wonders. One can only surmise that had Spengler lived to witness punk rock, heavy metal, techno, and rap music in the context of late 20th century America, he would have become even more convinced of his theory's correctness. Given the strong opinions of ancient physicians, philosophers, and statesmen about the effects of music, both positive and negative, our next question should be "Does modern research support these opinions in any way?" People living in modern industrialized nations have learned through painful experience that many of the wonders of technology have deadly side effects. Nuclear power was originally promoted as being clean and safe alternative to burning coal and oil. The ubiquitous plastics that promised to make our lives convenient are now recognized to be a major source of potent and dangerous hormone-disrupting chemicals. Excessive television viewing is now being recognized as a factor in learning and behavioral disorders in children. Could it be possible that music, which many of us take for granted as benign background noise, could have unrecognized effects, both harmful and beneficial? Research studies on effects of music on plants and animals The "Mozart Effect" Much of the current research in music therapy focuses on proving that music has measurable physiological and psychological effects. Such effects are not difficult to find or to measure, and are revealed by studies of human, animal, and plant behavior, EEG recordings, hormone assays, and cellular growth patterns. Frequently these results have been misinterpreted and exaggerated by the popular media and by marketing people, which is unfortunate, since the documented effects are remarkable in themselves. The so-called "Mozart Effect" is one such phenomenon that has resulted in much confusion. The "Mozart Effect" is based on research by Frances Rauscher et al., who determined that listening to 10 minutes of Mozart's "Sonata for Two Pianos in D Major" briefly increased scores 48% (relative to control groups) on the paper-folding task, a component of the Stanford-Binet intelligence test that measures spatio-temporal reasoning abilities. [3a, 3b] Moreover, the effects were transient, lasting only about 10 minutes, and performance on non-spatial reasoning tasks was unaffected. Such results seem to be unique to the music of Mozart, whereas music not as highly structured did not have measureable effects. Other researchers have demonstrated that compositions of other classical composers such as J.S. Bach show similar benefits. Listening to a few minutes of Mozart does not permanently make one smarter; however, the results of Rauscher's study, modest though they may seem, are profound. If such seemingly benign stimuli affect even momentary intelligence, one might wonder whether people exposed to specific types of music and sounds over extended periods would experience proportionately greater effects, both positive and negative. Using Baroque music to enhance learning a new language Bulgarian psychologist George Lozanov found that playing Baroque instrumental music (such as that of Handel and J.S. Bach) in the background while teaching foreign language vocabulary greatly increased student's speed of learning and degree of memory retention. Music with a metre close to 60 beats per minute was found to be most effective; that this rate closely matches that of a relaxed pulse is thought to be significant. (Handel supposedly composed his famous "Water Music" at the request of King George I of England to aid him with his poor memory; whether the music helped or not is undetermined.) [4a, 4b] Harmful effects of rock music on neuronal branching patterns in mice Physicist Harvey Bird and neurobiologist Gervasia Schreckenberg subjected different groups of mice to the sound of traditional voodoo drumming, to Strauss waltzes, and to silence, and then tested each group's ability to navigate through a maze to get food. [5a, 5b] All music was played continuously at low volumes to eliminate possible behavioral effects from loud sounds generally. The groups that were subjected to either silence or Strauss waltzes had no problem learning the maze, with the Strauss waltz group having a slight edge in performance. However, the voodoo group performed progressively worse over the period of time they were exposed to the music and eventually became so disoriented that they became unable to complete the maze at all. These mice were also hyperactive and aggressive, often engaging in cannibalistic behavior. On dissection of the brains of these mice, highly abnormal neuronal growth patterns were found in the hippocampus region, with excessive dendritic branches growing out in all directions yet making few connections to other neurons; the hippocampus region is known to be important in learning and memory formation. Significant increases in messenger RNA, which is involved in memory formation, were also found. This latter effect probably corresponds to the increase in dendritic branching, as if the brains were persistently attempting to make sense out the sound stimulus, but could not. A number of commentators have interpreted these findings to condemn all forms of rock music; while this does not necessarily follow logically from the Bird and Schreckenberg results, the Retallack experiments (see section 2.5, below) on plants at least suggests that many types of rock music may be harmful to human health. Some researchers and health professionals have suggested that the electronic distortion used by many rock bands might be a factor, in addition to the common use of anapestic rhythms (persistently syncopated, with two short beats, a long beat, then a pause). Effect of music on cortisol levels in humans Different types of music may significantly affect blood cortisol levels. Cortisol and adrenaline are two "stress" hormones that are secreted by the adrenal glands in response to ACTH. In one experiment, patients who had just been informed of their need for imminent surgery, were tested for blood cortisol concentrations after listening to a calming piece of music, chosen by each patient in consultation with a music therapist; cortisol levels were reduced by 50% compared with the control group that did not listen to any music. [6] In another experiment, this time with healthy people, similar results were obtained by playing sitar music by Ravi Shankar, whereas a waltz by Johann Strauss and a rhythmically irregular, somewhat discordant piece by contemporary composer W.H. Henze had no effect. Elevated cortisol levels are normal and desirable in certain circumstances, including high-intensity exercise. Trained runners are able to induce high levels of cortisol quickly without the aid of energizing musical accompaniment, but it was found that such music could aid untrained runners in producing such levels faster. Energizing music with a fast tempo had this effect, but slow, calming music did not, as might be expected. Perhaps sports team managers have always known this, thus the popularity of strident tunes played by brass bands before and during games to whip both players and spectators into a frenzy. One also might wonder whether certain types of agitating music, such as rock or heavy metal may induce excessive cortisol over extended periods of time and become addictive, in a similar manner to the adrenal rush one gets from coffee. Music and its effects on plant growth Plants have been shown to significantly increase their rate of growth when stimulated by specific sound frequencies. In the 1950's, Indian botanist T.C. Singh observed under a microscope the protoplasm streaming in an Asian aquatic plant, which normally increases at sunrise, and discovered that such streaming could be induced at other times of the day by activating an electrically driven tuning fork. He then experimented with recorded South Indian violin music played to a wide variety of plants, with frequencies of the fundamental tones in the 100 to 600 Hz range; significantly increased growth rates resulted. [7] About the same time, a Canadian named Eugene Canby began subjecting test plots of wheat to recordings of violin sonatas by J.S. Bach, and found that yields increased by 66%. Other tests in Russia, the U.S., and Canada with ultrasonic frequencies yielded similar increases in the growth rates of other plant species. Various researchers then determined that the range of frequencies around 5000 Hz were especially potent in stimulating plant growth. During the 1960's, researcher Dorothy Retallack determined that these frequencies were best administered in the form of classical music (compositions of J.S. Bach, Haydn, Beethoven, Brahms, Schubert, and other European 18th and 19th century composers; traditional North Indian music performed on sitar and tabla), played intermittently for several hours per day. [8a, 8b] A Minnesota plant breeder named Dan Carlson collaborated with a music teacher named Michael Holtz to create an audio tape with a combination of frequencies centered about the 5000 Hz range, which Holtz immediately recognized as being very similar to the sound of a bird chorus at dawn. Carlson then used this music to induce record-breaking growth rates in Purple Passion vine plants. [7] Retallack also experimented with various types of rock music to see what effects they would have on plant growth. Plants "listening" to selections from Led Zeppelin, Vanilla Fudge, and Jimi Hendrix became stunted or gangly, with long stems and sparse leaf growth, some bending away from the sound source; after 16 days, most of these plants died. Retallack also found that the discordant music of 20th century composers Arnold Schönberg and Anton von Webern also caused plants to atrophy, but not to the degree of the rock music. Schönberg is considered to be the father of 12-tone music, characterized by a total "freedom" from harmonic contraints, wherein all 12 tones of the western musical scale are ideally considered to be of equal weight and value. Twelve-tone principles of composition were eagerly embraced by avant garde faculty at music schools during the early 20th century, and over the following decades began to appear in popular music, and in background music for television and radio programs. The 12-tone style is what gives music for horror and suspense films its particular capacity to shock and terrorize. The key frequency range for inducing the relaxation response A French ear specialist named Alfred Tomatis confirmed that the same frequencies and musical styles Retallack demonstrated to be beneficial for plants were also beneficial for humans. [2b] Tomatis found that the types of music most likely to promote EEG, or brainwave, patterns correlated with relaxation of muscle tension and calm attentiveness were the same types of Baroque and classical compositions determined by Retallack to be optimal for plants, especially those recordings rich in stringed instruments, such as violin, viola, and cello. Specifically, the frequency range from 5000 to 8000 Hz seemed to promote alpha-band brainwaves the fastest; of all the musical instruments, stringed instruments are richest in these higher frequencies. Other research There are numerous other studies from hospitals and medical schools that have demonstrated effects of music on human behavior and physiology. Some results from these various studies are summarized here: Melodic intonation therapy, which involves speaking in a strongly musical manner, promotes recovery from aphasia in stroke patients who had failed to recover spontaneously after a prolonged period. Reactivation of Broca's area was verified by measurements of cerebral blood flow and PET scanning. [9a] Spatio-temporal math reasoning ability in second-graders is significantly enhanced by musical keyboard training. [9b] Mozart's music (Sonata for Two Pianos, K.448) has been shown to reduce total seizure activity in epileptic patients by 65%, when compared with silence and with "Old Time Pop Tunes", which had no effect. Moreover, the music was effective even for epileptics who were comatose at the time. [9c, 9d] Music has been shown to help reduce post-surgical stress and pain, to reduce symptoms of depression in home-bound elderly people, and to aid children who are developmentally delayed by enhancing hand-eye coordination. [10] Technical problems in reproducing sound for therapeutic purposes Modern CD recording technology and playback equipment has improved greatly over the past few decades, but still presents significant problems both for the therapeutic use of musical recordings and for the achievement of acceptable sound quality to musically trained listeners. While harmonic distortion and frequency response characteristics of playback equipment are well-known sources of audio degradation, most commercial equipment of reasonable quality merely degrades the audio signal so that recorded music lacks vibrancy, as if something is missing. While this may be disappointing, it is not a serious problem from a therapeutic perspective. At worst, some of the precious high frequency sounds may be lost, the very frequencies that researchers Carlson and Tomatis identified as being crucial to obtain the stimulating and energizing effects on plants and people. Music lovers who enjoy string quartets, for example, know that much of the electric excitement of listening to a good performance is lost in many playback systems because of poor reproduction of the high frequencies. While loss of high frequencies may be disappointing, most listeners can adapt to such defects. CD recording technology introduces a new source of distortion called jitter that is seldom officially acknowledged except by fussier audiophiles and audio equipment manufacturers. Jitter is a type of distortion introduced due to small errors in timing of the digital clock that drives the digital-to-analog-conversion component of a CD player. [11a, 11b] According to several sources, if this jitter exceeds 200 picoseconds, it becomes audible as a weird, persistent, but very quiet whistling or crackling sound. (I've personally listened to many systems in audio stores and have heard this phenomenon.) Trained musicians have often commented to me that they cannot stand to listen to any CD recordings for more than a few minutes without becoming irritable. Obviously, this type of distortion is unacceptable if one hopes to use the music to induce states of calm relaxation, focused attention, and other forms of bliss, if the jitter is subtly driving certain listeners mad. How much research in music therapy may have failed to reproduce the types of results discussed in section [2], merely because of poor quality playback systems, especially those that use CD players? (I have not been able to find any discussion of this problem in the music therapy literature, although many audiophile technical reports discuss it.) Using traditional Chinese medical (TCM) theory to understand and predict the effects of classical compositions on specific patterns of disharmony Music therapy researchers have commented that while it is relatively easy to prove that music can induce significant physiological effects, the nature of these effects varies among individuals and is a result of a complex interaction among the musical composition, the context in which a person listens to it, and the individual's personality and state of health. That not all people will react similarly to a specific piece of music is obvious to anyone who loves music, but explaining the reasons for these differences is considered by music therapy researchers to be so difficult that the question is usually avoided entirely. Standard research protocols with control and experimental groups, assuming homogeneous effects with variations around a statistical average, do not easily reveal why the music of a certain composer or a particular piece may awaken one person from a deep depression, yet evoke feelings of indifference or revulsion in others. As a clinical TCM herbalist, I've frequently used music as an adjunct to herbs and diet as a way to help people overcome the emotional and mental blocks that often accompany many health problems. On numerous occasions I've felt significant changes and improvements in pulse qualities while an individual listens to specific recordings of music. Traditional Chinese herbalists palpate an individual's radial pulse to feel a number of qualities such as rate, width, strength, rhythm, regularity, elasticity, and pulse profile; many pulse qualities are closely related to emotional and mental states that induce changes in either sympathetic and parasympathetic activity. In this section, we will explore how traditional Chinese methods of classifying patterns of disharmony and illness might provide the missing tool for analyzing and understanding why specific sounds, sound qualities, and pieces of music affect individual listeners differently. Such understanding is essential to use music effectively in a clinical setting. The following comments and ideas are based on my own experiences with clients, students, and friends over many years, combined with my understanding of Chinese theories of health and illness; they should be considered as tentative hypotheses for exploration rather than as dogma. Have fun with this section - obtain and listen to recordings of the compositions discussed below and discover whether you hear and feel the ideas I describe. TCM theory of sound qualities and their effects The effects of musical sounds and instruments is discussed briefly in ancient Chinese texts, much of it based on Five Element Theory. Five Element Theory is a somewhat simplistic system of phenomenological correspondences, or metaphors; students of TCM herbology will recognize it as inadequate to the level of discrimination necessary to choose herbs correctly, but with music as therapy, we are at a kindergarden stage of understanding, so some of its ideas may be useful in pointing us in the right direction. The following chart lists each of the five traditional elements followed by the emotions, organs, sounds, and musical instruments corresponding to each element: Fire: joy/mania, Heart/Small Intestine, laughter, stringed instruments (violin, viola, cello, etc.). Earth: worry/melancholy, Spleen/Stomach, song, human voice. Metal (Air): grief/sadness, Lungs/Large Intestine, weeping, brass instruments (trumpet, French horn). Water: fear/terror, Kidneys/UrinaryBladder, groaning, percussion and percussively activated instruments (drums, piano). Wood: anger/irritability, Liver/GallBladder, shouting, woodwinds (clarinet, oboe, flute). Another general set of rules we derive from Ayurvedic and yogic tradition regarding the effects of different sound frequencies on the different chakras, or levels of the body. Higher frequencies tend to affect the head region, lower frequencies the base of the spine and lower abdomen, and intermediate frequencies the chest and neck. This principle can be verified experientially by simply listening to a home audio system with good clarity and frequency response, and sampling recordings with both timpani (a type of drum with very low frequency response) and violin (which, of all the orchestral instruments, has the most energy in the high frequency range above 5000 Hz). Most people will report that the higher violin notes induce a distinct physical sensation especially at the top of their heads, whereas deep bass notes will be felt lower, either equally over the whole body or especially in the lower half. The preceding rules should not be taken dogmatically, but only as general tendencies. For example, almost every instrument can have effects on all the emotions, depending upon the precise musical content, such as key signature (major/minor), tempo, rhythm, loudness, melodic profile, contrapuntal technique, and other compositional features. The skill of great composers is reflected in the range of effects that they can obtain by using variations of these basic elements of sound. Our task is to attempt to correlate some of these sound elements and qualities with TCM elements of disharmony, to aid us in predicting which types of musical compositions might be beneficial for specific patterns of illness and disharmony (patterns of symptoms and clinical signs). This is a big undertaking, and rather than give you a long list of tentative and speculative rules, let's begin by exploring the use of various types of music for one specific type health imbalance that is very common in industrialized countries. Heart-Kidney non-communication There are several distinct manifestions of this phenomenon, but all of them may be associated with strong psychosomatic components, especially mental and emotional stress. As these are common maladies in modern industrialized countries, developing ways to resolve this inner tension in creative ways, rather than merely suppressing the symptoms with either drugs or herbal formulas, would be useful not only to the individual sufferers, but to their friends, family, and work associates as well. The several types of Heart-Kidney non-communication are as follows [12]: Heart-Kidney non-communication with Deficiency of Yang with mild Deficiency of Yin. Symptoms of this pattern generally include fatigue due to overwork and worry, intolerance of temperature extremes, dream-disturbed sleep, pale tongue appearance, and weak pulse. If severe, symptoms may also include watery diarrhea, spontaneous sweating and night sweats, dizziness, and palpitations. Heart-Kidney non-communication with chronic Deficiency of both Qi and Yin. Symptoms: irritability, fatigue, insomnia with restless sleep, inability to concentrate, forgetfulness, dry stools, tongue red with scanty coating, pulse rapid and thin. Heart-Kidney non-communication with Deficiency of Yin predominant. Symptoms: irritability with sensation of heat in the chest, insomnia characterized by an inability to relax and become calm while lying down, palpitations with anxiety, tongue red with dry yellow coat, pulse thin and rapid. Often occurs in the aftermath of high fever illnesses, but may also result from chronic mental stress with overconsumption of alcohol. A common emotional theme in all of the variations of Heart-Kidney non-communication is the mismatch between one's will and logical mind and one's emotional needs. For example, consider the case of a man (details changed somewhat) whose father strongly encouraged him to become a minister. He completed divinity school, was assigned to a parish, and discovered that, as an introspective and private individual, he dreaded dealing with large numbers of people and giving speeches. This man persisted, in spite of never-ending dislike of his profession, and eventually developed hyperthyroidism, which is one possible biomedical manifestation of Heart-Kidney non-communication. (Hyperthyroidism can also manifest as other patterns, including various Liver disharmonies.) The crisis over his health finally gave him a face-saving excuse to resign. His hyperthyroidism eventually resolved "spontaneously" after he became an engineering draftsman, work that he enjoyed. Such examples are common among people with hyperthyroid conditions I've seen over the years. The "Heart", or one's inner sense of knowing, when it becomes chronically frustrated by one's "Kidneys", or will power and reasoning mind, subconsciously sets the stage for a health crisis by revving the body's metabolism up to a chronically hyperactive state until the crisis is handled satisfactorily. This aspect is probably the central emotional theme of Heart-Kidney non-communication syndromes. Moreover, aspects of this emotional dynamic are present in most addictions: the individual suffering from cravings or addictions often consciously knows the nature of the problem, but the mere knowledge of this combined with sheer will power can only succeed in overcoming temptation for so long, unless the underlying unmet emotional needs are eventually recognized and resolved. Often this does not happen until the individual "hits bottom". Perhaps the biggest problem in an herbalist's practice is client non-compliance: people find the most creative ways to sabotage their own health, from repeatedly burning their herb tea on the stove, letting it spoil, forgetting to take it, and finding excuses and important business that prevents them from eating in a healthy manner. In many of these cases, it may be clear what they need to do, and even they recognize the situation, but find that their will (Kidneys) is at war with their emotions (Heart). In section [2] of this report I've already outlined the scientific evidence of the physiological effects of music. In my personal experience as a clinical herbalist, the one single pattern described by Chinese herbology that responds more powerfully to music than any other is Heart-Kidney non-communication. Next, I'll describe in detail specific musical compositions that I would consider good choices for each of the three types of Heart-Kidney non-communication, and the reasons why each works. Before we get into specific compositions, I need to preface them with one note of caution: each of the compositions below involves stringed instruments, and not everyone likes the sound of violins, violas, and cellos. I've found that, often, those individuals who are most averse to the sound of these instruments have some type of disharmony related to Stagnation of Liver Qi and related disharmonies, and will describe the sound as being shrill and irritating. It is quite possible for Heart-Kidney non-communication patterns to coexist with many other patterns, including Liver Stagnation disorders, and if this is the case, the rules governing choices of herbs as well as music become more involved. The general principle of Chinese herbology that one must remove Excess before tonifying Deficiency applies here. One cannot introduce either nutrient herbs or "nutrient" sounds to an area of the body if it is tight or blocked in some manner. In such cases, purging, draining, and clearing methods may be necessary prior to administering tonifying, or restorative, qualities. The best way to experience the following music is to play the recording at a comfortable and realistic volume, but not so loud that potentially annoying distortion effects of your audio system become apparent. You should turn off the room lights, preferably at night when the room can be darkened entirely, and lie down on a comfortable surface while listening. If listening with a group of people, it is best that everyone close their eyes to avoid looking at others to see how they are reacting. Chamber music, in contrast to public parades and festivals, is often an intensely private experience, and should be enjoyed that way. String Quintet in C major (D 956) by Franz Schubert According to traditional Chinese theory, stringed instruments are the preferred means of creating sounds that will affect the Heart most intensely. String trios, quartets, and quintets consist of at least one or more cellos, a viola, and one or more violins. The cellos produce the lowest tones of these three instruments, and violins the highest. The Ayurvedic theory of the chakras states that the lowest frequencies will affect the lower chakras (lower abdomen), which corresponds to the aspect of the Kidneys in Chinese theory. The sound quality of the Kidneys is that of groaning, and while this might sound unattractive, cellos are capable of groaning in such a captivating manner as to induce states of ecstasy. They are sexy instruments. Violins, while also having a beautiful sound, predominantly stimulate the head region. Together, in the hands of a great composer, such as Schubert, cellos and violins can sometimes create the distinct effect of shivers that extend all the way from the base of the spine to the top of the head. This shivering effect is the physical sensation that I look for in an individual to let me know whether their Kidneys and Heart are "communicating". This is not some abstract and very subtle New-Agey phenomenon; either you feel it, or you don't. If you've never experienced this, you need to obtain a recording of Schubert's Quintet and try this out immediately: Schubert, Franz; "String Quintet in C major (D 956)"; performed by Emerson String Quartet with Mstislav Rostropovich, cello; Deutsche Grammophon, CD recording, c1988. Schubert composed the C major Quintet during the last few years of his life, when he knew he was dying. Each of the four movements portrays a general mood of intrepid optimism interwoven with some of the most ravishing melodies ever written. As happens with many people who learn of their imminent death, Schubert was possessed by an intensity of focus during his remaining years to create music uniquely his own rather than composing to satisfy the conventions and expectations of others. The Quintet was not performed until 20 years after his death, but was eventually acclaimed an icon among chamber music compositions, by which others would be compared and judged. Analysis: Though the composition as a whole is based in the key of C major, Schubert begins the first movement with a melodic opening that soon slips in and out of the minor mode with a persistent burst of staccato (percussive-like) chords; percussive-like sounds affect the Kidneys, especially if these sounds contain lower frequencies, here provided by the growling sound of the two cellos. Minor modes, in general, convey a sense of somberness, mystery, or hidden meaning in contrast with major modes, which have a lighter and more transparent nature. The alternating major and minor modes combined with the sharp, strident effect of the staccato passages have the effect of shocking the listener to attention; they grab one's ears forcibly. The overall effect is energizing, awakening, and sharpening of the senses. At approximately two minutes into the first movement, the strident introduction is followed by the main theme of the first movement, a melodic development section, first carried by the cellos, and then shifting to the violins in a higher tonal range (also incorporating several examples of harmonic modulation). Many listeners experience "chills" or shivers up the spine during this section, a masterpiece of melodic and contrapuntal technique. Schubert gives the listener two more chances to "get it", as this section appears a total of three times during the first movement. Each occurrence is preceded by a repeat of the opening theme, the strident-energizing section. The first movement of the Quintet is one of the best examples of the use of different frequency ranges and a range of playing styles, including plucking, staccato, legato, and an almost aggressive bowing of the strings, to create various energetic effects in the listener. The Kidney Qi is energized by the lower frequencies of the cello and by the staccato and plucking techniques, and these help to harness the energy and excitement of the listener so that all the senses are at maximum attention. Then, when the legato-style melodic sections appear, the Heart is ready to receive the message. As some people may take more time to build up to this level, Schubert generously prolonged the first movement to a total of almost 20 minutes, with multiple repetitions of the energizing and the melodic sections. During the legato sections of the first movement, Schubert employs the technique of harmonic modulation to shift the key signature to progressively higher keys at the same time that the melody is tending upward. This combination induces a potent effect analogous to kundalini surging upward through the chakras, and can result in headaches in certain individuals, especially if they suffer from Stagnation of Liver Qi. Focusing on completely relaxing the neck and facial muscles may reduce this tendency; Schubert's Quintet is not appropriate for people who have significant Stagnation of Liver Qi or other blockages of an "Excess" nature. The remaining three movements extend the dialog between Heart and Kidneys, with variations on the themes and styles of the first movement. While the first movement presents the energizing effects and the highly melodic sections alternately, the second movement begins to integrate these two effects into a unified whole. Its first half consists of a slow, pensive melody with a meter of 3/4, providing a somewhat rocking motion; in contrast to the first movement, it provides the listener with a moment to daydream and to contemplate the ideas and agitated excitement created during the first movement. Halfway through the second movement, we are again agitated by a restless, more passionate development of the melody accompanied by a repetitively rolling, growling theme in the cellos. During this section, the restless Kidney energy emanating from the cellos smoothly integrates with the melodic line of the violins and violas for the first time in the Quintet. At this point, most listeners will begin to feel the sense of internal conflict diminish. Some individuals may experience this activation of Kidney energy as waves of tingly sensations over their legs and lower torso, or perhaps even as involuntary muscle twitching. The third movement begins with a jubilant, optimistic scherzo in major mode. Open fifths dominate the harmonic structure, creating a potent, physically energizing effect. At points, the harmonics verge on dissonance, but the effect is one of joyous and wild abandon rather than discord. Heart-Kidney non-communication disharmonies are often accompanied by a fear of violating convention to the point of suppressing one's own inner needs, and this section represents symbolically and energetically casting away this burden. This dance-like scherzo is followed by an Andante sostenuto section, slower and more pensive, echoing the melodies of the second movement, followed by a repetition of the jubilant, almost raucous dance with which the movement began. The fourth and last movement echoes the scherzo of the third movement, but with a sense of determination and force of will rather than wild abandon. The energy of the Kidney has been harnessed, and the Heart and Kidney link together in a single-minded clarity of purpose. The final notes of the Quintet, a confident, but ominous sounding series of pure octaves, leave one with a sense of absolute resoluteness. (Some listeners may experience a kinesthetic echo of these final octaves as a series of body rushes -- waves of tingly sensations or perhaps a slight sense of dizziness as if on a merry-go-round that suddenly stops.) Overall, what better way to transform a person fearful of change into a tiger? Other compositions for the three types of Heart-Kidney non-communication Other compositions that have similar qualities to the Schubert Quintet in C major are: Piano Sonata #23 (Op.57 "Appassionata") in F minor, by Ludwig van Beethoven (In: Beethoven, Ludwig van: Complete Piano Sonatas / Deutsche Grammophon, ©1965 [9CD]; Wilhelm Kempff) Symphony #1 in C minor (Op.68), by Johannes Brahms (In: Brahms, Johannes: Symphony #1; Schumann, Robert: Symphony #1 / Deutsche Grammophon Originals, ©1964, 1972 [1CD]; Berlin Philharmonic Orchestra, conductor Herbert von Karajan) Due to the intensely energizing, hot-blooded effect these compositions may induce in some listeners, they are most suited for the pattern of Heart-Kidney Non-communication with Deficiency of Yang and mild Deficiency of Yin. If the Deficiency of Yin is more severe, with increasing symptoms of restless activity, insomnia, and Interior Heat, such individuals may experience excessive agitation while listening to the Quintet and to the other compositions listed. Ayurvedic physicians would probably classify these compositions as being rajasic in quality, as they provoke one to take action. (Black and cayenne peppers are examples of rajasic herbs.) For Heart-Kidney Non-communication with chronic Deficiency of both Qi and Yin, a more calming, balanced approach is necessary. A few examples of chamber music compositions that meet these criteria are: Sonata for Violin and Piano #3 (Op. 108) in D minor, by Johannes Brahms (In: Brahms, Johannes: The Violin Sonatas/ EMI Classics, ©1985 [1CD]; violinist Itzhak Perlman, pianist Vladimir Ashkenazy) String Quintet #2 in G (Op. 111), by Johannes Brahms (In: Brahms, Johannes: String Quintets #1 (in F major) and #2 (in G major) / Naxos, ©1996 [1CD]; Ludwig Quartet, Bruno Pasquier) Mysterious Mountain, by Alan Hovhaness (In: Hovhaness, Alan: Mysterious Mountain; Stravinsky, Igor: The Fairy's Kiss; Prokofiev, Sergei: Lieutenant Kijé/ RCA Victor, ©1957-58 [1CD]; Fritz Reiner, Chicago Symphony Orchestra) The preceding selections, in combination with listening to music of Handel, Haydn, and Mozart are generally more appropriate for Heart-Kidney Non-communication with chronic Deficiency of Qi and Yin, as such music tends not to agitate the emotions, but instead, provides a more harmonious sense of mental clarity. Ayurvedic physicians would probably classify the music of these composers as sattvic, promoting balanced stimulation of the higher chakras without inducing either agitation or melancholy. Moreover, because Heart-Kidney Non-communication with chronic Deficiency of Qi and Yin also includes symptoms of poor memory and difficulty thinking, the music of Haydn and Mozart is especially appropriate, having been shown by researchers to be useful for these symptoms specifically. For Heart-Kidney Non-communication with Deficiency of Yin predominant, one requires a more soothing, gentle sound. Non-agitating, calming music, especially choral music, is especially appropriate for this condition. In choirs with sopranos, altos, tenors, baritones, and basses, all the frequency ranges are covered, which is important to achieve the desired effect, similar to combining cellos and violins in the case of string chamber music. The tone quality of a mixed choir will be mellower than that of a string ensemble. A few compositions that fit these criteria are: Mass in B Minor (BWV232), by Johann Sebastian Bach (Bach, J.S.: Mass in B Minor / Telarc, ©1990 [2CD]; Atlanta Symphony Orchestra and Chorus, conductor Robert Shaw) Requiem (Op.48), by Gabriel Fauré (In: Fauré, Gabriel: Requiem; Durufle, Maurice: Requiem / Telarc, ©1987 [1CD]; Atlanta Symphony Orchestra and Chorus, conductor Robert Shaw) Impromptus (Op. 90, 142), by Franz Schubert (Schubert, Franz: Impromptus Op.90 and Op.142 / Philips, ©1997 [1CD]; pianist Mitsuko Uchida Guidelines for future research There is sufficient research that demonstrates music has potent physiological and psychological effects, confirming the general beliefs of ancient physicians and philosophers that music can be both beneficial and dangerous. Only the most doctrinaire people will refuse to recognize this fact, and even more research will not convince them. What would be most helpful now are more clinical studies and research into the specific qualities of music and how these affect different types of people. Additionally, it would be wise for researchers in this field to pay more attention to the nature of the music selected and the quality of sound reproduction (very few talk about or even know about digitally generated jitter) before jumping to conclusions about the effect or lack of effect of a specific experimental protocol. It is astounding to me how many research articles report in detail on the experimental design and statistical methods used, but make no mention of the sound reproduction equipment or even the identity of the musical compositions used in the study, except to specify "classical" or "rock". I hope to have stimulated others into considering the idea that Chinese herbal methods may provide researchers a useful classification system for distinguishing which types of music might benefit specific indiduals and why. The ideas presented in this paper are my own, based on years of observing others and their interaction with classical music compositions, and they are subject to change. But one must begin somewhere, and this is a modest beginning.