Book Review - Tuina Therapy
by Errol Lynch
I was happy and honoured to be given the opportunity to review this book. Tuina is a very exciting therapy to teach and to be involved in. It was an honour to be given the opportunity to receive an early copy of a new Tuina book alongside reviewing it.
The look of the book (hard copy) was really impressive. The publishers of Tuina Therapy (Thieme) have a good reputation and have a range of books covering many aspects of complementary medicine. As an experienced Tuina practitioner the blurb caught my interest:
"Other books may only contain brief sections on Tuina therapy”
After reading such claims my expectation naturally grew. The best two sections of the book are the appendix and the glossary. I found the appendix of good use and the acupuncture channels very clear and easy to use. The glossary was also well laid out and used Chinese characters and pinyin that are generally missing from many other Tuina books that are produced outside of China.
Other sections that were impressive in the book were the self-help section for adults. This was clearly laid out with one model throughout the entire section, fully dressed with little change of clothing and arrows assisting the directions of the hand manoeuvres. The slight exception was the introduction of Mo Fu, (round rubbing) the abdomen, there was no picture or illustration and no instruction on Mo Fu, especially as Mo Fu was not mentioned in the common hand techniques in the first section.
Throughout the whole book I found it well laid out and the pictures were clear for accompanying the syndromes. Some of the book had arrows assisting the pictures, helping me to clearly understand the direction of the manipulation. But this was not consistent throughout the book; many times I was left to guess which way the manoeuvre was going to be.
To the eye the book looked well laid out but I did find the book very difficult to follow and read. Some of the words used were not what I was use to and had to look up them up for greater clarity. Maybe this was due to my experience of Tuina and bias of clothed Tuina, also as I have routines, thoughts and ways of doing Tuina already in my head.
I did not want to prejudge the work and wanted to be fair to the authors, so in my next teaching class I set a task for the students, to use this book and another Tuina book by an English author. A competition was that the students had to choose a similar routine from each book then they had to read and complete the routine, no time limit was set, just which of the teams finished first. The task lasted thirty minutes. Both teams that participated in the contest found the words used in the Tuina therapy book hard to understand for example "repletion”. The routines were very difficult to follow and although there are pictures they felt this was not enough. They found the routines to be disjointed as they had to manoeuvre the patient from prone to supine to seated to prone too many times, both found teams that they could not continue to the end of the routine. They did joke and role play with undressing midway through the massage routines as demonstrated by the authors.
The day after I was travelling to China on a Tuina study tour and feeling I did not do Tuina and the Tuina book any justice, I carried the book with me. Whilst there I asked two of the Tuina doctors from the Zhe Jiang hospital of TCM to help me to review the book Tuina Therapy. They returned the book after two days and asked me if it was mine, they expressed their opinions that the book was very difficult to follow and they found it difficult to read any further and they did not finish reading of the book. The doctors commented that the use of the pictures was of little use as they found them difficult to follow.
Tuina is an active and moving therapy, and the manoeuvres used in the book were not clear for example the An Fa could be Rou Fa that could be Tui Fa, so the pictures did not help indicate the constant movements of the hand technique. Neither of the Doctors commented on the lack of clothing used by the models.
The book demonstrated a two man manipulations for the dorsolumdar syndromes, which I find very complex and I feel should not be taught in this way. They should be taught under supervision in a classroom or in a hospital. This is on page 35 the assisting practitioner should hold the patients legs very firm, to stop the patient moving from side to side. The patients legs should be together, the picture indicates that they are held separate. The main practitioner should support the vertebra at the point they feel are displaced, so they can be adjusted through the range of the manoeuver. This can be a very dangerous technique and can cause serious harm to a patient if performed without proper care.
The continuity of the model in the pictures throughout the book was a little bit strange. At the beginning of a sequence the model is fully dressed and then in the middle of the sequence she is partially dressed, and at other times undressed or a change of top or leggings, and sometimes it is a totally different model in the middle of a sequence. It breaks up the fluidity of the routines. Page 55: Elbow forearms and hands the model is topless with Tui Fa used on the bladder channel fig 2.42 then the model is changed to performed gun fa on her arm fig 2.43, for fig 2.42 there are appropriate pictures on page 15 and 19 the same fully clothed model fig 2.43. (This treatment is for elbow to hand, therefore there should be no need to start the patient topless).
Page 106 the treatment for headache fig 4.14 another topless model fig 4.15 change to another full dressed model to have a patient in a seated position then have them topless is very hard for their modesty.
While learning Tuina in China none of the patients were ever asked to de-robe or undress, and that has been consistent throughout my training in Shanghai, Beijing and Hang Zhou for the last twelve years. During this time if we wanted to apply medical creams or ointments to the skin of the patient then we would lift the clothes, apply and then replace clothing. Granted if the model is naked of the benefit of the student to see where the technique is exactly applied, then the author should indicate this within the text. Internationally, Tuina has the reputation for being a fully clothed medical treatment, similar to shiatsu and Thai massage.
I feel that at the beginning of the paediatric section, there should be an explanation telling the reader that this is a self-help treatment for home use. The accompanying pictures I find inappropriate for the child to be laid against a Tuina practitioner (male or female) in this way. The illustrations in the book should be filmed in a clinic setting so the Tuina practitioner will learn posture and their own body positions.
On page 112 Gynecological and Obstetric Indications, figure 5.2 shows an inappropriate technique. A lady coming to a male practitioner with any complaints of the above, are usually vulnerable and nervous, and to put her in a supine position, legs open, then to have a male practitioner to rub the inner thigh I find unprofessional and unnecessary and should not be taught to students of Tuina. If necessary for this technique, there should be the correct towel draping method.
After reading the book extremely carefully a number of times I find it very difficult to recommend this book to UK Tuina practitioners. At the beginning of the book the individual techniques haven’t been explained in full with the terminology. The main techniques introduced in the beginning of the book is Tui, Rou, Na, An and Gun Fa. Other techniques were introduced in section two with no clear explanation of the individual technique. Technique like Ban Fa should be introduced in the first section, as it is one of the more complex and definitely most disastrous if done wrong. Many of the techniques are introduced into the sections of disorder, rather than in the first section of Foundations, Basic Techniques, Tuina treatment for Adults.
Errol Lynch has been a teacher of Tuina since 1999 and a Tuina practitioner for the last 14 years. He has studied in Beijing, Shanghai and Hang zhou, under the following professors: Professor Fan Bing Hua, Professor Zhang Qiang Professor Li Hang, Doctor Jiang, Doctor Ye, and worked with many other Doctors from the City hospital Hang Zhou and Zhe Jiang provincial hospital both in Hang Zhou City. He is the guest speaker to the first Tuina symposium 2010 China. Prior to Tuina practice he became qualified in Chinese herbal medicine and Japanese massage. He can be contacted at: errol@Tuinauk.com.