TUINA

The Jiang-Su Provincial Hospital of Nanjing, China, is a foundation of mainstream medical practice combined with traditional Chinese medicine Here, an e!panded understanding of the human bod" and its functions are approached with complete balance-the best of both health-care worlds Health care is an issue in China because there are so man" people who need care Holistic, or ancient Chinese medicine, is often less costl" to the public than mainstream medical treatment #t$s a ver" efficient wa" for the medical care s"stem to operate in China, using more of the old wa"s to treat the bod" in health and disease through a provincial hospital such as this Ta%ing care of a bab" who has special medical or health needs can become challenging for a parent #n Chinese traditional medicine, a bab" under a ph"sician$s care ma" have Chinese Tuina acupressure massage as a main treatment for mild medical conditions such as colic, and also be given a mainstream medical plan for severe conditions Chinese Tuina massage currentl" is found as a main health-care regime in more than &' percent of "oung infants$ medical-care cases in China # found this ama(ing as one can onl" imagine just how man" massages that several million children and adults receive in China ever" da" Tuina is now being introduced to the outside world Since China was not alwa"s open to an" t"pe of entr" into their societ", # felt ver" luc%", as an )merican, to be included in a stud" group with the best pediatric division in China # was not alone # met a woman having a small bo! lunch outside the hospital grounds She was stud"ing at Jiang-Su, researching cancer for Johns Hop%ins *niversit" in +altimore She told me that the level of doctors$ s%ills at this medical facilit" is a rarit" in our ,estern world -" doctor and teacher, .r /in -ing, head of the pediatric division, is a daint" woman, about ' feet 0 inch tall with great compassion for the infants and children who come to her for treatment She studied in her home countr" to become a medical doctor and acupuncturist, and then speciali(ed in pediatric Tuina, or Chinese massage, for small children .uring our sessions, her daughter accompanied her and translated Chinese medical te!t into 1nglish so we could understand

Learning Tuina
Tuina massage is an important component of traditional Chinese recover" therap" in which diseases are cured b" the operator$s manipulations of the patient$s bod" to stimulate the energ" meridians, collaterals and points The earliest record of Tuina treatment in China is in the /ellow 1mperor$s #nternal Classic, a medical treatise published in the fifth centur", + C #t includes a chapter on blood, 2i 3energ"4 and mental5ph"sical conditions as the" relate to the Tuina treatment of diseases )ccording to 6uan Chang"e, an infant-Tuina e!pert in +eijing, 7,hen a person is in fre2uent shoc% and the passages of the meridians, collaterals are bloc%ed, disease attac%s him mostl" in the form of numbness, and should be treated b" massage This indicates that Tuina therap" is able to promote the circulation of 2i and blood, remove obstructions of the meridians and collaterals, and benefit joint movement 7The bioph"sical and biochemical changes of the muscles resulting from massage are evident These biological changes invigorate l"mphatic flow, facilitate blood circulation, and strengthen metabolism, thus reducing swelling, preventing hemorrhage and old bleeding 3also called $eliminating the stale and stagnant$4, tonif"ing the tendons and bones, strengthening the contraction of the ligaments, and pla"ing a bilateral function in sedating the nerves and inhibiting analgesia 7)ll these facts have proved that Tuina therap" is able to relieve organic diseases and to eliminate functional disturbance This therap" is simple, economical and free from side effects, sparing not onl" infants from the bitterness of medication and the pain of injections, but also their parents from worr" #nfants cooperate with, and easil" accept, this therap" because the manipulations produce comfortable sensations on their bod" surfaces 7 +ecause it is relativel" eas" to learn, Tuina infant therap" can be readil" taught to parents to appl" at home

Hands-On Learning

6earning from the other doctors in the clinics at the hospital was a practical hands-on techni2ue ,e learned through direct contact with babies and mothers 1ven after spending the time learning the holistic Chinese medicine approach, however, # feel there is still so much to learn from their ancient wa"s The Chinese base all medical treatment on the functions of the elements in nature Heaven, earth and the elements found in the bod" are the tools b" which the" diagnose and treat s"mptoms The balance of these elements with one another in the human bod" often determines the outcome of focused treatment Herbs, plants and their essences that affect this balance are available now in modern forms ) good bab" massage provides rela!ation and often relief from pain, such as colic, when applied properl" #t is alwa"s a good idea to determine the general health of a bab" through a mainstream doctor before beginning an" massage or holistic therap", to be sure there is no contraindication for the direct application

What You Need

)romatherap" oil3s4 or unscented lotion -usic source8 tape or C. pla"er to pla" soft, soothing music 9ne or two e!tra diapers on hand, just in case Stuffed animals, or soft s2uee(able to"s +ab"$s sleeper with blan%et for dressing after a massage

However, massage is not a replacement for mainstream medicine :or e!ample, one would use mainstream medicine to treat a bro%en bone with an ;-ra" and a cast ,hen a bab" has colic, though, a massage, combined with aromatherap", for the digestion ma" be indicated ,hat pu((led me most was the e!pectation of the doctors in China that each patient needs to accept more responsiblit" for his or her own health # then came to reali(e that we ,esterners have poor %nowledge of what the Chinese do concerning health care Chinese patients have to e!plain themselves to their doctors-their habits, functions, diet 3did the" eat too man" fried foods<4, e!ercise regimes, and career, as well as the home-life environments that the" created for dail" living #f a child had a pree!isting poor health condition and the parents alread" %new about it, the" often were scolded for waiting too long for treatment #n comparison, )mericans, as a whole, are just learning to accept full responsibilit" for their health This all leads to an interesting point8 -assage is not an e!travagant e!pense in China #t is a wa" of life to promote good health in the human bod" ) "oung infant is a blind stud" for massage Since a bab" has no previous programming about the ph"siological effects massage ma" have on the bod", he or she does not %now how or wh" it feels good

Value Of Touch
-assage and human touch have a common thread globall" Throughout histor", most people have shown a common need to give and receive love, and to nurture and care for other human beings, especiall" one$s own famil" The deep inner drive from -other Nature sets the stage for human need to nest and procreate +efore a bab" is conceived, there is ph"sical contact, often accompanied b" love, between parents The child is the result of ph"sical contact between man and woman, meeting in the act of love, intimac" and touch )fter birth, the bab"$s instinctive survival mechanism is a drive for ph"sical connection to the parental figures Touch creates human emotions and feelings

Fig 1. Making baby ready for massage. Even with the smallest of infants, ACHT hormones can be stimulated in the brain.

-assage can become an integral part of a bab"$s life for "ears to come Parents who have learned how to give their bab" a massage often sa" how wonderful it is to receive massage bac% from their children as the" grow older The aftereffects of massage seem to live on in our children Parents comment when the" come home after a hard da" of wor% to find their children eager to give a foot massage, and a rela!ing shoulder massage, accompanied b" tic%ling, giggling and laughter Parents often sa" how glad the" were to have learned how to establish positive touch, communication, and to give their children pediatric massage

Acupressure For Ba !
+egin b" placing a towel on the flat surface where the bab" will be positioned for the massage Protect the surface 3such as carpeting or other4 from spilled oil, lotion or cream b" alwa"s placing the bottle on the towel -a%e sure the container is out of reach of the child$s hands, which are ver" bus" and are moving all the time Start the music, pla" with the to"s for a while, and begin b" following the instructions for bab" massage ) bab" massage usuall" ta%es => to ?' minutes, and is best given an" time, but especiall" in the following cases8 +efore nap time@ ,hen bab" has digestive pain@ )fter bab"$s bath@ +efore -om has important 2uiet time for herself

Please note that man" more acupressure points e!ist in this therapeutic Chinese techni2ue However, onl" the most commonl" used, and the safest, points for babies are included here

Fig. 2. Infantile frontal acu ressure oints.

Ba !"s #hest Acupressure $oints

3See :igure =4 Tiantu- 6ower throat suprasternum fossa@ for congestion relief %han&hong- -iddle of sternum@ for coughing, stuff" chest, asthma, vomiting and nausea 'ugen- +elow nipple, front of bod"@ for lungs, cough and phlegm (ielei- +elow intercostal rib areas@ relief of abdominal chest accumulation of phlegm

Ba !"s %to)ach Acupressure $oints

3See :igure =4 Fu!in!ang- *pper abdomen@ for stomach, spleen and digestive relief *hong+an- -iddle of stomach@ for stomach, spleen and digestive relief ,u-i- Navel area@ for abdominal digestion ,antian- -iddle of lower abdomen@ for strengthening %idne"s, digestive relief and hernia ,u.iao- +elow bell" button@ for digestive relief and diarrhea Tianshu- Two thumbs lateral from the bell" button@ for movement of food, constipation, indigestion and digestive relief

Fig. 3. Infantile facial acu ressure oints.

Ba !"s Face Acupressure $oints

3See :igure ?4 *an&hu /or Tianting0- -iddle of forehead@ soothing nerves and headache relief Tai!ang- Sides of e"ebrows@ offering relief to e"e area Ying1iang- Near nostrils@ reducing fever Yanguan /or 2iache0- 6ower mandible@ facial trauma, paral"sis and mouth opening 'en&hong- The point of great balance@ for di((" spells and trauma 3r)en /or Feng)en0- -outh opening at mandible@ for toothache, paral"sis of face, convulsions, tinnitus and deafness #heng.iang- Start at center of the chin and massage toward jaw to /anguan acupressure point This can be used for tightness in the jaw, facial paral"sis and relief from inflammation during ear infections

Acupressure For Ba !"s Face

3See :igure ?4 *huntou- -assage upward from tip of nose toward forehead to Shangen, -ei!en, Tianting, ;inmen to +aihu 3top of head4 3See below for massaging ;inmen 4 This can be used for soothing nerves, headache relief, blurred vision and nasal congestion relief (in)en- 6ightl" stro%e forehead from middle of forehead to e"ebrows to the top of forehead to hair This Chinese acupressure techni2ue ma" relieve convulsions, spasm, tension of e"es, blurr" vision, di((iness or nasal congestion 3See :igure A 4

Fig. 4. !orehead acu ressure massage.

Fig. 5. Infantile dorsal acu ressure oints.

Ba !"s Bac4 Acupressure $oints

3See :igure '4 2i&hu- 6umbosacral region on bac%@ for soothing the central nervous s"stem, malnutrition, diarrhea, vomiting, abdominal pains and constipation $ishu- 1leventh thoracic vertebrae on bac%@ helping function of spleen, digestion and chronic wea%ness -i.iegu- :outh lumbar vertebrae on bac%@ for diarrhea, d"senter", prolapsed rectum and constipation 5ui+ei- Tip of cocc"! on bac%@ for diarrhea, d"senter", abdominal pain and prolapsed rectum Chang Biang- Tip of cocc"!@ for intestinal inflammation

Ba !"s Nec4 And %houlder Acupressure $oints

3See :igure '4 -iaogong- Side of nec%@ for rigidit", stiffness and pain in the nec% area 3rhougaogu- +ehind ear@ for restlessness, calming and congestion of the head ;injian- Second and third cervical vertebrae@ clearing the throat, helps congestion, sort throat and heat Tian&hu- Hairline at bac% of nec%@ for stiff nec% and common- cold headaches ,a&hui- Seventh cervical vertebrae at bac% of nec%@ for heat, common cold, fever and vomiting Feishu- Third thoracic vertebrae on bac%@ for lungs, relief from coughing and asthma

Fig.6. "eibagua acu ressure oint is found in the center of the alm of the hand. It#s functions are to reinforce the s leen and increase digestive movement in a calming way.

Ba !"s Ar) And Hand /$al)0 Acupressure $oints

3See :igure &4 %anguan- Cadial border of forearm@ for digestive relief, cold and wea% arms Tianeshui- -edial border of forearm@ for fever, cold relief, restlessness and irritabilit" Liufu- *lnar side of forearm@ cooling the bod" during heat spells, deto!ification and clearing heat that the bod" stores Nei agua- )round in a circle in the palm of the hand, rotate gentl" cloc%wise@ harmoni(ing the cough, diarrhea, abdomen, digestive pains, food digestion and abdominal pain relief 3See :igure D 4 ,aheng+en- 9n the wrist crease, palm up@ press the point gentl" with both thumbs and do fulling to outer wrist Can relieve vomiting, chills, fever, asthma, spitting- up, food stagnation, abdominal distension and diarrhea

Fig. 7. Acu ressure oints on the inside of a baby#s arm and hand. *ong.in- -idpoint of the wrist crease on the palm@ %nead with thumb gentl" 0' to => times, cloc%wise Can be used for convulsions, mental stress, diarrhea, vomiting and mouth ulcers Yu.i.iao- -iddle end of wrist crease on the palm@ tap the point lightl" seven to eight times with pointer finger Can be used for stopping convulsions, easing the mind, brightening the e"es, clearing pathogenic heat, epileps", blurred vision, redness, pain and swelling of the e"e, e!cessive cr"ing Ban)en- The second phalangeal joint of the thumb near /uji@ hold, rub the point with thumb gentl" cloc%wise &' to 0>> times Can be used for acute or chronic convulsions and indigestion Neilaogong- #n the center of the palm@ %nead gentl" cloc%wise ?> to &' times Can be used for convulsions caused b" fright, reducing fever of common cold and e!cessive heat $i.ing- The radial side of the thumb between the tip and the base of the thumb To reinforce spleen 3can be used for constipation4, stro%e toward the heart 0>> times and for reducing 3can be used for diarrhea4 stro%e awa" from the heart 0>> times (in.ing- The tip of the middle finger Stro%e toward the heart for reinforcing 3diarrhea relief4 and awa" from the heart for reducing 3constipation relief4 Fei.ing- Tip of ring finger@ hold point for ?> seconds Can be used for the common cold, cough, asthma, spitting- up and constipation %hending- Tip of the littlest finger@ %nead the tip gentl" &' to 0>> times Can be used for night sweats Yunshuirutu to Yunturushui- :rom tip of little finger, forming a half- circle, all the wa" to the base of the thumb :or d"suria, "ellow urine and constipation Hongchi- Crease of the forearm@ guide fingers gentl" from Hongchi up to Tianshui at the crease of wrist to Ehongjian Can be used for fever, cold, mental stress and e!ternal cold Yinchi- Fentl" stro%ing 6iufu 3si! :u organs4 awa" from heart, toward wrist Can be used for fever, cold, restlessness and irritabilit" %anguan- Stro%e gentl"@ radial border of forearm between crease in arm all the wa" to crease in wrist Can be used to strengthen /ang energ" or treat e!terior 3common cold4 s"mptoms from pathogenic factors

Fig. 8. Acu ressure or her arm.

oints on the back of baby#s hand and outside of his

Bac4- of- the3See :igure G4 Yi+ofeng- The 3top of bab"$s wrist4@ press

Hand Acupressure $oints

depression of the middle of the wrist at the crease the point with inde! finger or thumb about &' to 0>>

times for warming the middle jiao, promoting circulation of 2i, relieving abdominal pain and stopping joint pain Weiling- The top of the hand between second and third metacarpal bones, beside the ,ailaogong point@ press the point two to five times with the tip of thumb, then gentl" rub after pressing This point can resuscitate from coma, and is good for tinnitus, headache and unconsciousness caused b" acute convulsions 2ingning- 9n the top of hand beside ,ailaogong point between the fourth and fifth metacarpal bones Press the point with thumb two to five times, and then gentl" %nead for about 0> seconds -a" help with asthma and e!cessive spitting- up, palpating the lumps in the abdomen or gass" full stomach and chest area Wailaogong- #n the center 3of the top4 of the hand opposite Neilaogong point Hnead the point for three to five minutes gentl" Can be used for warming the "ang energ" of the bod", diarrhea, d"senter" from common cold, prolapsed rectum, ascariasis, hernia and borbor"gmia Bo!angchi- Stro%e gentl" toward wrist from anterior middle of the forearm Can be good for promoting circulation and digestive relief

%etting Up The 6assage %pace

,arm- to- moderate room temperature Soft, muted lighting for bab"$s sensitive e"es and to promote calmness :lat surface to set massage oil, lotion or cream for stabilit" purposes ) flat, safe area for "our bab" to receive a massage, such as the floor or changing table

3rshan)en- #n the center of the top of the hand in the depression between the third and fourth metacarpal bones Press the point three to five times gentl" Can be used for promoting better circulation of blood and 2i rela!ing tendons, and good for asthma, cold from wind, stiffness in the chest, spitting- up and clearing common cold s"mptoms Laolong- The tip of the middle finger Press three to seven times Can help to resuscitate an unconscious bab", stop convulsions, reduce fever and pathogenic fire 2i 3e!cessive heat4 ,uan&heng- )t the middle finger nail root 3base of nail4 Press sides of bab"$s middle finger with thumb and inde! finger 3as to s2uee(e4 three to seven times Can help with d"senter", diarrhea, vomiting and spastic colon 3r)a- 9n the top of the hand in the depression between the ring finger and the little finger Hold and gentl" rub the point with thumb up to =' times Can be used for reinforcing the "in energ" of 2i in the bod", d"suria, indigestion, prolapsed rectum, abdominal pain, wea% bod" constitution, cough, asthma and difficult" e!pelling to!ins Tian)enruhu4ou- +etween thumb and inde! finger 3top of hand4 Press point up to &' times Can be used for smoothing circulation, clenched teeth, sore throat and fullness in the chest Wu&hi.ie- 9n the top of hand of all five fingers 3phalang- ometacarpal joints4 Press points three to five times Can help with resuscitating an unconscious bab", stopping convulsion, and calming the bab" %hi1uan- )ll five tips of fingers Press points one to three times Can be good for resuscitating unconscious bab", acute convulsions, dull behavior and cr"ing fits This article was adapted, with permission, from The 6ittle +ab" -assage +oo% b" 6inda 1llen 6arson Cop"right 0III 3) new edition of this boo% will be available this fall 4

Ac4no+ledg)ents
The author wishes to than% the following people for their help in creating this article8 Neil Jameson, photograper and -arg )nne Jameson, editor of boo%@ Paul Titangos, photographer@ 6inda 6ev", computer5graphic5web- designer@ Stacie Sheridan, illustrator of bab" images@ bab" model, )ndre Hat( 3parents Ca2ib 6"nn- Hat(, 6 )c and John Hat(4@ .r Hen 6ubowich, 9 - . of China )cadem" of Traditional Chinese -edicine, * S :oreign 9ffice@ .r /in -ing, 9 - . , - . , the Jiang- Su Provincial Hospital of Nanjing, China