Each individual Chinese medical practice is holistic, treating the patient and not the disease. Each is very versatile yet has a main focus and strength. For that reason, most acupuncturists, Qigong doctors, and Tuina practitioners include herbs in their practice. Many Qigong and Taiji instructors teach their students and patients about lifestyle and dietary factors, and some offer acupressure or Tuina treatments. Not every physician integrates or even practices all modalities, but to get the fastest, most comprehensive resolution to a health problem or to live the healthiest possible life into a vital old age, all should be included and conscientiously integrated to best support each individual regularly, as is most often done in China. That will become more apparent as you proceed through the following chapters.
Acupuncture is the art and science of encouraging the body to improve function and promote natural healing by inserting very fine surgical-grade stainless steel needles (see Appendix 2, Note 11.1) into select acupoints found along discrete, well-defined energy pathways called meridians. The diagnostic methods discussed in Chapter 10 are used to identify patterns of disharmony, and points are selected accordingly to restore the body to healthy balance by influencing the flow of Qi within the meridians and their related organs.
Each point has specific functions. The primary point functions usually relate to the function of the organ associated with the selected meridian or to the condition of the meridian itself, which can have its own related set of indications. No organ is ever needled directly. Examples of point functions for nearly one hundred points are found in Chapter 13.
Acupuncture’s main strength is in moving Qi. The ways in which it moves Qi and for what purposes are discussed in the next two sections. Acupuncture on its own does not add Qi to the body. (By using the adjunctive therapy of moxibustion, Yang Qi can be added.) It builds Qi by strengthening the functions of the organs that are responsible for acquiring and producing Qi, primarily the Lungs and Spleen, so a treatment may feel immediately energizing, while building sustainable energy over time. More commonly, patients feel calm and relaxed. Acupuncture moves Blood by moving Qi, which is the commander of Blood. Acupuncture builds Blood by strengthening the functions of the organs that generate Blood, primarily the Spleen and Heart.
Needling Sensations: Deqi
It is a common misunderstanding that there is no sensation associated with acupuncture treatments. In fact, some sensation is required in order for the treatment to be most successful. The needling sensation is called Deqi (De Qi), or the “arrival of the Qi,” and indicates that the Qi has been accessed.
For the physician, Deqi feels like a grabbing around the needle at the site of its insertion. Then the needle can be most effectively manipulated, guiding the Qi to produce a variety of effects and providing the best therapeutic outcomes.
For the patient, typical Deqi sensations include feelings of distension, heaviness, tingling, electricity, temperature change, internal motion, and tightness, among many other possibilities. Sometimes these sensations can be quite strong, and a new or very sensitive patient may interpret them as pain. Once a patient knows to look for a variety of needling sensations, they rarely perceive them as pain. It is possible to feel true pain when a needle is inserted, because there is a fine network of cutaneous nerves that spread across and just below the surface of the skin, and occasionally one of those nerves may be punctured. While that is not dangerous, it will provoke the type of pain usually associated with a pinprick, and it is usually much less painful than a hypodermic needle injection. Just as no organ is ever directly needled, no nerve is ever intentionally needled.
Acupuncture needles are manipulated using a variety of techniques to move Qi in specific ways, initiating or amplifying specific healing responses. One of the most dramatic techniques is used in acupuncture anesthesia. In that case, an acupuncturist selects the appropriate points and then twirls two needles very rapidly, 120 to 180 times per minute, for five, ten, or even twenty minutes. An acupuncturist must have a fair amount of personal Qi cultivation in order to be able to maintain such manipulation. While that was done historically, these days most acupuncturists opt for electroacupuncture, an electrical stimulation of the needles, to approximate the same effect.
In everyday use, less demanding manipulations are performed primarily to tonify (gathering Qi to the acupoint or encouraging Qi flow in the normal direction of the meridian pathway) or to sedate (dispersing Qi away from a point or encouraging Qi flow against the normal direction of the meridian pathway).
Tonification is performed to strengthen the functions of an acupoint and its related organ, to build Qi, Yang, blood, or Yin in a weak or deficient patient, or in other patterns indicating deficiency. Sedation is performed to dispel an external pathogen, to open a channel obstruction and reduce pain, or to reduce the presence of any internal excess (such as Damp accumulation) in any pattern indicating excess.
When a needle is not stimulated at all, it is a harmonizing treatment, providing a general balancing without overtly tonifying or sedating a point.
Points are combined in specific ways to create therapeutic effects. There are many classic two-point, four-needle combinations that have powerful effects, due to the unique attributes of the selected points. Usually, many more than two points are used in any acupuncture treatment. Dozens of point combinations used to treat common ailments are found in Chapter 18.
Treatment frequency can vary some based on the severity of the condition being treated and whether an integrated approach, adding herbs and Qigong therapies, is being followed. With acupuncture alone, once a week is a standard minimum, though twice a week is better, and in China it’s common to be treated every day or every other day for ten treatments as one course of treatment. This is because the effects of acupuncture peak in two to three days and then begin to decline. Boosting the effects of treatment every day or two maintains a steady increase of improvement. This is most important when treating any serious condition.
In minor to moderate conditions, one to two treatments a week are usually sufficient. If herbs are taken daily, they provide another benefit and enhance the effects of acupuncture. If the patient practices Chinese healing exercises, Qigong, Taiji, or the acupressure that’s taught in this book, another layer of healing is added daily, and one acupuncture treatment each week is enough. For general health maintenance, a “tune-up” type of treatment, or a periodic energetic assessment and rebalancing, one or two treatments per month works well.
While this is a common protocol, acupuncturists can have differing strategies. If you are in treatment, follow the recommendations of your acupuncturist.
Three Case Histories
The following three cases will give you some context through which to understand how and why number and frequency of treatments can vary, and why your expected number of treatments may be ultimately unpredictable. Patient names and other minor details have been changed to protect their identities, but these are otherwise accurate synopses from my records.
Allergies and Eczema
John, a man in his midthirties, came to see me with two long-standing problems: a cat allergy and eczema that covered parts of his arms, legs, ears, and torso. At that point in his life, he was particularly motivated to get relief from his allergy. His fiancée had cats and told him in no uncertain terms that she was not getting rid of them, so he had to find a way to deal with it.
Since airborne allergens primarily affect the lungs, and since the Lungs dominate the skin, it was easy to see how these problems were related. It’s fairly common for people with childhood asthma to develop eczema, psoriasis, or other skin conditions later in life as the pathology moves deeper and transforms. This was a variation of that pattern, now presenting with allergies instead of asthma, which had in fact afflicted John in his youth.
There were two difficulties in resolving these conditions: the length of time he’d suffered them (the longer a pathology is in place, the deeper it will penetrate the body), and the nature of the pathology itself, Damp.
Described as being thick, sticky, and cloying, Damp can be very intractable. It manifested as Phlegm swelling the mucous membranes in his sinuses, airways, and lungs, which compromised his breathing. It secondarily manifested through the eczema on his skin.
The other pathogenic factor was Heat, which manifested most as the redness, heat, and itch of the eczema. It caused symptoms in other parts of his body as well. Hot, damp environments exacerbated his eczema.
Examination revealed that Lung Qi Deficiency was the main pattern—this was likely constitutional—and the Spleen and Stomach were also involved. I explained these things to him and told him that it wouldn’t be a fast and easy recovery. I recommended twice-weekly acupuncture treatments and daily herbs. As an additional therapy, I recommended some dietary modifications and a high-quality bovine colostrum supplement, which supplies immunoglobulins and balances immune response, to address the allergy from a nutritional/orthomolecular standpoint. Part of the Lungs’ function of dominating the skin is roughly analogous to the role of the general immune system, so this approach made sense to me.
As he’d exhausted all other medical options, John agreed to this treatment plan. He was one of my most compliant patients, rarely missed an appointment, and was diligent in taking the herbs and colostrum daily. While we saw slow, steady improvement over time with some expected brief setbacks, it took six months to resolve the cat allergies. At that time, he was able to play with the cats and remain asymptomatic.
His eczema symptoms showed less improvement, but he was so encouraged that he continued treatment to fully resolve it. After a few months we reduced the frequency of his treatments to once a week, although he continued to take herbs daily. It took nearly an additional year and a half to resolve the eczema, but through all of that time, the cat allergy never returned. After two years of treatment, the eczema cleared, and he only experienced brief minor flare-ups in his elbow creases when he had to visit hot, humid environments for work. He reported that it was otherwise no longer a problem.
Everything about this case proceeded as expected. The constitutional component, the number of years the condition existed, and the Damp nature of the primary pathogen all indicated a long course of treatment, even with twice-weekly acupuncture and the daily use of herbs and supplements. As the eczema was a later, hence deeper, manifestation of the primary Lung weakness, it naturally took longer to resolve.
Sudden Onset Deafness
Ethan was a man in his early thirties who came to me through a referral about a week after he awoke one morning with a complete loss of hearing in his left ear. His primary care provider told him that a virus had invaded his auditory nerve, and that if he were any older, he would probably not regain any of his hearing. Being young and otherwise healthy, the doctor prescribed steroids and antibiotics, saying by following that regimen for between eight and twelve months, he could have up to 50 percent of his hearing restored. (Antibiotics do not treat viral infections, so that part of the treatment didn’t make sense to me. I did not speak with his doctor directly, so it’s possible Ethan was mistaken about that medication.)
Due to the seriousness of his condition, I said that I’d be willing to treat him if he would come for acupuncture every other day. I believed we would not make much progress with fewer treatments, and I did not want him to otherwise think Chinese medicine didn’t work. He agreed, so I gave him a first treatment that day, on a Friday. He came back on Sunday, saying he already had some hearing return. On Monday, he called to tell me that by his estimation, he had at least 25 percent of his hearing back, and decided to go on a week’s skiing vacation that he and his wife had planned but then cancelled to accommodate his treatment schedule.
Ethan came for his third treatment a week later on a Monday and told me he had an appointment with his audiologist the next day. On Tuesday, after seeing the audiologist he called to say he had 86 percent of his hearing restored and didn’t feel he needed any further treatment! I never saw him again, so my assumption was that, subjectively at least, his hearing was fully back to normal.
I expected that Ethan would require at least two courses of ten treatments over five to six weeks, including an herbal prescription that we never got to. The rapidity of his recovery was a pleasant surprise but not implausible. His hearing loss was both of sudden onset and very recent, so the pathogenic factors did not have time to penetrate deeply and take a strong hold. He was smart to seek help as soon as he did. Being young and healthy, he had abundant Qi to work with, so the effects of the acupuncture were maximized even without the inclusion of herbs.
Barry, a man in his late twenties, lived in Los Angeles. During the summer, he bicycled from LA all the way across the country to Boston and developed a very painful, debilitating wrist tendinopathy from the continual stress of the ride. The doctors he consulted in Boston put him on anti-inflammatories, told him to rest his hands and apply ice, and said that in time it should improve but that surgery might become necessary. His doctors in LA continued the anti-inflammatories, prescribed physical therapy, and were adopting a wait-and-see approach before considering surgery. In late October it was still painful and difficult for him to use his hands.
Referred by a friend who was my patient, Barry came to see me in San Francisco while he was there on a months-long work assignment. After diagnosing him with Channel Obstruction (a type of localized Qi stagnation) with Blood Stasis and Heat, I recommended twice weekly acupuncture, and an herbal formula I’d have ready for him on his next visit. He agreed, and I gave him the acupuncture treatment that day.
The next night, Barry called and excitedly told me he’d been pain free since the previous evening, and asked me to hold off on picking up his herbs. The next day he called to cancel the treatment we scheduled for the following day, saying he’d reschedule if his pain returned. Weeks later, his friend who was my patient confirmed that Barry had remained pain free since his single acupuncture treatment.
Barry’s amazingly rapid recovery was a big surprise to me. Even though he was young and healthy and followed all the conventional Western approaches to treat his condition, he’d been suffering unrelenting pain for months, so I expected it would take at least a few weeks for him to improve.
These examples illustrate that it is difficult to say with complete certainly how long a course of treatment will be necessary. In John’s case, it took about as long as I’d expected. Although I let him know it would take significant time, he stuck with it, and we got the results I anticipated. Ethan improved much sooner than I thought likely, but there were circumstances that explained in part why that might have occurred. Barry’s recovery was so rapid and complete that I concluded this was one instance where we got really lucky, that the treatment I gave him was perfectly targeted to his exact needs. It sometimes happens that way, but it’s a rarity.
This involves attaching electrodes from an electroacupuncture device to the handle end of inserted acupuncture needles. A very low current is run through them to produce specific effects. The microampere range generally strengthens the main effect of the treatment. Microamp current is thought to closely duplicate the body’s natural Qi and stimulates stronger Qi flow through the selected meridians. It typically produces a tonifying effect but can be used for sedation. The milliamp current range causes muscles to contract in a way similar to stimulation by a transcutaneous electrical nerve stimulation (TENS) device. This is a sedation effect, disperses Qi stagnation to reduce tension and pain, and is used in preoperative acupuncture anesthesia. The selection of microamp or milliamp stimulation depends upon the condition being treated and the therapeutically desired effect.
This is an aspect of herbal medicine. It involves the burning of an herb called Ai Ye (Chinese mugwort) or “moxa” as a type of heat therapy or to add Yang Qi to specific points or to focused, relatively small regions of the body. The Qi of moxa is thought to be nearly identical to the Qi of a human and is especially beneficial for weaker patients or those with Cold conditions.
Moxa can be in the form of cigar-sized cylinders. One end is lit, and the hot tip is moved toward the patient’s body to treat the desired regions, often in a pecking motion, although the lit tip never touches the patient’s body. It may also be in loose form and rolled into rice-grain-shaped pellets, which are then placed on acupoints and lit. When the patient feels the heat, the pellet is removed. This may be repeated many times.
Moxa may also be placed in a small pile, usually on the navel, on a slice of ginger, Fu Zi (aconite, monkshood, wolfsbane), salt, or other substance and then lit. The therapeutic properties of the other substance are added to the moxa, which may be left in place or removed if the heat feels too strong for the patient.
Involves creating a vacuum in small, thick glass cups and rapidly placing them on the patient’s body to create a localized suction. This can be used to draw out pathogens, or when moving the cups along meridian pathways after lubricating the skin, to strongly open the affected meridian, moving both Qi and blood. This is commonly done on the back to open the Urinary Bladder meridian, which is useful for treating the onset of colds, fevers, and headache and for muscle tension from channel obstruction.
Western Perspectives on Acupuncture
Until recently, Western medical interest in acupuncture has largely been limited to pain management. In that context, gate control theory, discussed in Chapter 2, has been proposed as one possible mechanism. Another involves the release of endorphins, the body’s “endogenous morphine.” Endorphins are pain-relieving neuropeptides produced by the nervous system and pituitary gland and are believed to be stimulated by the needle insertions. This is also cited to account for acupuncture’s effectiveness in addiction treatment. It fits the Western medical model nicely, but acupuncture’s effects go far beyond pain management, so these are limited explanations.
Another posits that needling acupuncture points induces the nervous system to cause the release of other biochemicals beyond endorphin neuropeptides (neurotransmitters, neurohormones, endocrine and exocrine hormones) into the muscles, organs, spinal cord, and brain. They can influence the body’s internal regulating systems or trigger the release of still other biochemicals. The improved biochemical balance supports the body’s natural healing abilities, promoting physical and emotional health.
Since the mid-1990s, PET scans and fMRI technologies have demonstrated that parts of the brain light up corresponding to the traditional understanding of points used for specific purposes. For example, needling a point in the foot known to benefit the eyes lights up the optical region of brain.19 Some of the most studied points have a wide range of clinical applications, including LI 4, St 36, P 6, Liv 3, and GB 34. These points influence large areas of the brain, including somatosensory, motor, auditory, and visual areas, the cerebellum, the limbic system, and higher cognitive area. Brain maps of acupuncture points belonging to different meridians vary considerably, while points belonging to a single meridian affect the same single region of the brain.
Imaging also corroborates the organs’ ascendant times (see Chapter 5), showing a different level and type of brain activity when points are needled during the related organ’s ascendant time than at other times of day. These and many other studies demonstrate that acupuncture affects the body in ways corresponding to thousands of years of traditional understanding. As of yet, there is no explanation for how it achieves those results within a Western medical paradigm.
For thousands of years, Chinese medicine has been used to treat virtually every medical condition that conventional Western medicine does. Each system has its relative strengths and weaknesses, which hopefully will one day make them truly complementary partners in the Western world as they are in China.
In a 2003 internal document titled Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials, the World Health Organization published this updated list of conditions effectively treated by acupuncture. The full document is available for download from the WHO website. While far from exhaustive in regards to the benefits possible from the totality of Chinese medicine, it provides a credible foundation from a globally acknowledged source as a basis for Western understanding.
Upper Respiratory Tract
• Acute sinusitis
• Acute rhinitis
• Common cold
• Acute tonsillitis
• Sore throat
• Acute bronchitis
• Bronchial asthma
• Recurrent chest infections
• Angina pectoris
Disorders of the Eye
• Acute conjunctivitis
• Central retinitis
Disorders of the Mouth
• Toothache, postextraction pain
• Acute and chronic pharyngitis
• Spasms of esophagus and cardia
• Acute and chronic gastritis
• Gastric hyperacidity
• Chronic duodenal ulcer (pain relief)
• Acute duodenal ulcer (without complications)
• Acute and chronic colitis
• Food allergies
• Acute bacillary dysentery
• Paralytic ileus
• Spastic colon
• Nausea and vomiting associated with chemotherapy
Neurological and Musculoskeletal Disorders
• Headache and migraine
• Trigeminal neuralgia
• Facial palsy
• Facial tics
• Pareses following a stroke
• Peripheral neuropathies
• Sequelae of poliomyelitis
• Meniere’s disease
• Neurogenic bladder dysfunction
• Nocturnal enuresis
• Intercostal neuralgia
• Cervicobrachial syndrome
• Neck pain
• Various forms of tendinitis
• Frozen shoulder
• Tennis elbow
• Low back pain
Emotional and Psychological Disorders
• Alcohol, nicotine, and other drugs
Urinary, Menstrual, and Reproductive Problems
Herbal medicine is Chinese pharmacology. Herbology is older than acupuncture and central to the practice of Chinese medicine. It can produce all of the effects of acupuncture, but its main strength is that it adds something to the body. While this is useful in all conditions, it may be especially valuable for Deficient conditions, since the substance of herbs can readily build Blood and Yin, along with Qi and Yang.
Although plant sources make up the largest part of its pharmacopoeia, animal and mineral substances are also employed. Oyster shell, earthworm, and mantis egg casing are commonly used. Tiger bone and other endangered-species animal parts were once commonly used but are now illegal and no longer included in contemporary Chinese pharmacies or patent medicines. (A patient can request no animal products. In that case, plant substitutes may be used.) Some minerals (like talc, gypsum, and hematite) can be found in “herbal” formulas.
Its meticulous detail and many well-defined treatment strategies make Chinese herbal medicine significantly different from its Western herbal counterparts. Those distinctions are discussed in Chapter 14. A Chinese herbalist will create a complex, balanced formula or possibly modify or combine any of thousands of established formulas. The herbalist takes the whole person into account and addresses the overt symptoms, secondary issues, underlying causes, and the constitutional needs of the individual, based on a detailed diagnosis. Used this way, herbal medicine is very safe, is very effective, and produces no side effects.
Chinese doctors continually expand their pharmacopoeia and have incorporated many Western and other nonlocal herbs over the millennia. They do this by analyzing the new substance according to its taste, temperature (or Qi), the channel or channels it enters, its compatibility with other herbs, and its potential toxicity. Only then do they include it in the Chinese pharmacopoeia. It’s more about the way the herbs are applied, the rationale, rather than any intrinsic quality of the herb that makes it part of Chinese medicine. As an example, American ginseng, native to North America, is now a valued part of Chinese herbal medicine.
Forms of Chinese Herbs
Traditionally, herbal formulas were prepared by combining loose herbs and decocting them into very potent teas. This approach is still favored by most herbalists since it allows for precise customization of the formula content and dosages, which can be easily modified to accommodate changes in a patient’s condition over time. This method produces the strongest and most predictably accurate therapeutic effect, since the effects of most of the formulas described in the Chinese pharmacopoeia were derived from decoction. Many herbalists contend that preparing a formula by decoction creates an interaction among herbs, modifying some of their actions to achieve the most desired results. Cooking them together alters their biochemistry.
The downsides of this approach include the amount of time spent brewing the decoction—a daily dose typically takes about forty-five minutes of cooking time—and the way they smell and taste, which many Westerners find unpleasant. There may also be more variability in the quality of the herbs used, since they are not standardized. Differences in soil composition, geography, length of the growing cycle, and the time of harvest, among other factors, all influence the potency of the herbs.
Chinese herbal formulas are available as patent medicines in tablet form, and varieties of herbal tablets or pills have existed for hundreds of years. Since these tablets are still whole herbs and not synthesized, concentrated pharmaceutical drugs, many more tablets must be consumed than most Westerners are used to. Depending on the form and size of the tablets, anywhere from nine to thirty-six tablets may be required daily. These are premade formulas and therefore not customizable, but there are literally hundreds of formulas available in tablet form. A close match may be readily found, and often two formulas may be used simultaneously for a more targeted outcome.
Pills were used historically most often in chronic conditions requiring an extended course of treatment. That may be one reason a physician might select tablets for US patients, but a more common reason is that Westerners are used to taking pills and are more likely to continue using herbs if given in that form.
Herbs are available as tinctures (usually an alcohol-based extract which may be added by dropper to a cup of hot water), granules (powders which are dissolved in a cup of hot water and then drunk), and as medicinal wines. Although granules are available as complete formulas, they are also available as single herbs. This makes granules a good compromise between loose herbs and tablets, since they are more readily customizable by adding one or two single herbs to a formula, don’t make the house smell of herbs, and don’t require any cooking time on the part of the patient. In the case of medicinal wines, the wine itself often supplies a part of the therapeutic effect and is used in a narrower range of applications than tablets, tincture, and granules.
After discussing the relative merits of the various forms of administering herbs and making recommendations, your physician will usually let you choose which form you prefer.
Western Understanding of Herbs
Western science exclusively views herbs in the context of their constituent components—that is, their vitamin, mineral, enzyme, and alkaloid content. This is a reductionist view, in keeping with much of Western medicine. Western pharmacology might try to isolate the “active ingredient” and extract it away from all the other parts of the herb that make it a whole, complete, natural substance. If it proves useful in a Western medical application, they will later synthesize that ingredient as a patentable drug, further distancing it from its natural origins.
To better understand why this is usually not a desirable approach, consider that when you extract the vitamin C from an orange, you do not get the bioflavinoids necessary for its most complete bioavailability and utilization, any of the fiber, nor any of the other minerals and enzymes that make it a whole, healthy food. When vitamin C is synthesized, even though touted as bioidentical to what is in the orange, your body is less able to absorb and utilize that concentrated synthetic substance.
In fact, in some well-known Western medical studies, synthetic versions of vitamins, notably vitamin E and beta-carotene, were shown to increase the risk of cancers and heart disease in some populations. This is similar to the occurrence of side effects in synthetic drugs, only more insidious since it raises doubts in the minds of some people about vitamins that are indispensable to good health in their natural forms.
Most Western doctors are woefully ignorant about herbs in any form, so they perhaps wisely tend to err on the side of caution, counseling their patients to avoid the use of herbs when taking pharmaceutical drugs to treat any condition. This is usually to avoid the risk of unwanted, potentially harmful interactions.
One of the most common examples is blood thinners. Patients on blood-thinning medications are routinely told to avoid garlic, ginger, aloe vera, and a few other common herbs and foods that thin the blood, to avoid excessive bleeding risks. From a holistic perspective, this is exactly backward thinking. Doesn’t it make more sense to eat a lot of garlic, ginger, and aloe vera and stop taking medications? The same holds true for many other conditions, which most often can be safely and effectively treated through dietary changes and herbal (and other nutrient) supplementation. While they do have their place and can be lifesaving, all pharmaceutical interventions present the risk of unwanted side effects even when used as directed. Properly used, herbs and foods do not.
Physical therapies may be passive, as when a patient receives treatment in the form of acupressure, Tuina (a type of medical massage), bone-setting (Chinese chiropractic), or medical Qigong. (Bone-setting is not legally allowable in the United States under Chinese medical licensure, so it is not discussed here.) They may be active, as when a patient is taught to perform Chinese healing exercises, Qigong, or Taiji to address specific medical issues for themselves. Not every Chinese physician includes these in their practice. Some do, and many may refer patients to specialists in these practices.
Acupressure and Tuina
Acupressure follows the same principles as acupuncture, without needles. Its main strength is the same as for acupuncture, with the added benefit of more immediately opening areas of obstruction, thereby reducing pain, when direct pressure is applied to painful points. Acupressure is also suitable as a means of self-care for the general population, as taught in this book.
Physicians manually stimulate the acupoints with their fingertips, their knuckles, their palms, the edge of the hand, and, for some points, their elbows. There are many techniques used to tonify and sedate points. Some techniques are selected based on the part of the body being treated. For example, techniques on the face need to be finer and more delicate than those used on the glutes. This type of treatment is less likely to follow an acupuncture treatment on the same day, as it may be redundant. Treatments typically take between twenty and fifty minutes.
Tuina, meaning “to push and pinch,” is another related type of bodywork, superficially resembling Western massage. It has its own techniques, many involving the pushing, lifting, and squeezing its name implies, along with rolling, grasping, shaking, and tapping and patting, among others. Its main strength lies in addressing acute and chronic pain, musculoskeletal disorders, and digestive or respiratory disorders that are caused by stress.
While acupressure’s main focus is on the points, Tuina has a larger, whole-body focus. Joint mobilization is employed to free up joint restrictions. Tuina may contain a strong Qigong component, addressing the body in as much of, or possibly more of, an energetic way than purely physically. In that case it is sometimes distinguished as “Qigong Tuina.” Tuina can include bone-setting in regions where that is legally allowed. Tuina may be employed directly after an acupuncture treatment, since it is not specifically a point-based therapy. Treatments typical take between thirty and sixty minutes.
There can be some overlap between acupressure and Tuina. Often a practitioner is equally accomplished in both modalities, and techniques from one practice may be beneficial for a patient being treated in the other. In China, specialists in these healing disciplines receive as much medical training as acupuncturists and are held in similarly high regard.
This term is sometimes used to mean a Qigong one practices oneself for a specific medical purpose, but here we are referring to a physician who uses Qigong to treat a patient. Since medical Qigong can be very draining and leave the physician open to the many pathogenic factors afflicting their patients, the Qigong doctor must first become a very adept Qigong practitioner for their personal cultivation.
All of the principles of Chinese medicine are followed in medical Qigong. The Qigong doctor directly manipulates the Qi of the patient, sometimes using some physical touch but most often involving no or minimal physical contact. Tonification is obtained by the physician directly infusing Qi into the patient. Sedation involves directly drawing the pathogenic Qi out of the patient. The physician directs Qi flow within the body of the patient to open channel obstruction or obtain harmonization. These things can only be done once the physician is able to tangibly perceive the Qi within the patient’s body and primarily utilizes Waiqi (Wai Qi), or the externalization or projection of Qi.
These are the three main ways this projection of Qi is accomplished:
1. The doctor uses his own Qi to treat the patient. This is very demanding and can seriously deplete the doctor. I’ve known a few Qigong doctors who practice Qigong six to eight hours a day for their self-care for this very reason. One of my acupuncture teachers told me of Qigong doctors she knew in China who healed hundreds of patients but died young themselves due to such serious depletion of their own life force.
2. The doctor stores environmental Qi within himself, like a storage battery, and uses only that Qi to heal patients. While this is less draining than using one’s own Qi, it can become tricky to distinguish between stored environmental Qi and one’s own.
3. The doctor focuses celestial and terrestrial Qi, using only that and none of his own. This may be safest for the doctor, but there is some risk of becoming a perpetually “open circuit” for any external influence, which can be both physically and psychologically destabilizing.
Other more esoteric options such as induction into spiritual lineages are beyond the scope of this discussion.
Chinese Healing Exercises
Some physicians teach their patients Chinese self-healing exercises. Each of these simple exercises may be performed in just a minute or two. Some address the whole body at once, but most target small body regions to open localized restriction or obstruction, moving Qi to reduce pain and increase functionality. Since these are easy to learn and take little time, many can be learned quickly and combined prescriptively to address a wide range of specific medical concerns or to promote overall health. Like all active physical therapies, they can be performed daily to optimize their many health benefits. More information can be found in Chinese Healing Exercises: A Personalized Practice for Health & Longevity. (See Recommended Reading at the end of this book for more details.)
Qigong and Taiji
Qigong is discussed thoroughly in Chapter 16 and taught in Chapter 17, so it will only briefly be introduced here. Qigong involves working with Qi, the energy of life. It has hundreds, perhaps thousands, of forms, each with unique applications. They can improve health in a general way, target an individual Organ System to strengthen it or heal specific illnesses, help develop athletic or martial abilities, increase longevity, promote spiritual cultivation, or simply help one achieve excellence in secular endeavors. The type of Qigong you practice will make a difference in the results you experience, although there can be overlap among styles. For holistic healing purposes, practicing Qigongs that target Organ Systems, as are taught in this book, will give you the best outcomes, whether your goal is to maintain or improve upon your good health or to heal from illness, injury, or debility.
Taiji can work in similar ways to Qigong. It was developed as a martial art, although it can be modified to primarily access its healing qualities. There are many such variations available today. The single most significant difference is that even these modified forms are more lengthy and involved than most Qigongs. If your immediate needs are for healing, Qigong is likely a better option since you can learn it more quickly and access its healing benefits sooner. If you are healthy, learning Taiji is a great option for preventive maintenance, optimal health, physical strengthening, and self-defense if you’re interested in that aspect. Then you will have it already available if you need to draw on it for healing at a later time.
As an important part of integrated natural healing, Qigong or Taiji specific to your health needs can and should be performed daily. With practice, both enable you to acquire more Qi. They enhance the effects of acupuncture/acupressure and herbs and support a healthy lifestyle.
Diet and Lifestyle
Diet and lifestyle are discussed extensively in Chapter 7. This brief summary of reminders may serve as a useful guide on your journey to better health.
Daily diet and lifestyle choices are among the things over which we have the most control. They often become ingrained habits and are not given much thought, which can make them difficult to change. The changes become easier if we first become mindful and then tackle them one at a time, replacing poor or careless habits with conscientious new ones that promote health and happiness.
There are very few things that will cause illness or injury unless done to excess or at the expense of other important elements of life. As in all other aspects of Chinese medical thought, balance is the key. Work must be balanced with recreation, activity with rest, wakefulness with adequate sleep.
When a person is in balanced good health, even exposure to external pathogenic factors will not cause illness unless the exposure is prolonged or intense. Strive for equanimity in all facets of emotional experience, and you’ll reduce the possibility of imbalance due to internal pathogenic factors as well.
Regulate your daily schedule as much as possible by getting enough sleep (seven to eight hours) during the same hours each night and eating your meals at the same time each day. Balance your diet by including all of the Five Flavors each day. For most people, that means reducing sweet, salty, and spicy flavors and increasing bitter and sour flavors. In general, that involves cutting back on sugars and carbs and increasing vegetables and some fruits. While a simplification, this is at the core of most contemporary dietary recommendation. (See Appendix 2, Note 11.2.)
The best specific food advice for restoring health from a Chinese holistic perspective is found in the prescriptions in Chapter 18.
Try to eat organically and avoid genetically modified foods and ingredients. All traditional dietary advice precedes the advent of the now-common commercial methods of food production, including synthetic chemical pesticides, herbicides, fertilizers, and genetic modifications. The nutritional content and safety of commercial foods have altered dramatically since their traditional organic origins. As they are many steps removed from nature, they can no longer be considered part of a truly holistic lifestyle.
Avoid allowing yourself to become exhausted on a regular basis. This includes sexual exhaustion. You may want to include aspects of sexual regulation as previously discussed. Be mindful of the Five Exhaustions (see page 125). If you should exhaust yourself, do all you can to rest and replenish as soon as possible.
Diet and lifestyle are integral parts of creating or restoring and maintaining balance and harmony. This includes supporting the natural balance among all the Yin and Yang energies within us and harmonizing with and attuning to the hours of the day, the passage of the seasons, and the stages of our life. We are all products of nature and are optimally served by aligning ourselves with the rhythms of the natural world. This is the best way to avoid depletion, degeneration, and premature aging and is necessary to produce the abundant Qi and Blood required to maintain energy and good health throughout all of our years.
19. Kathleen K. S. Hui, Jing Liu, and Kenneth K. Kwong, “Functional Mapping of the Human Brain during Acupuncture with Magnetic Resonance Imaging Somatosensory Cortex Activation,” World Journal of Acupuncture-Moxibustion 7, no. 3 (1997): 44–49.