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Active Health Foundation

James OSullivan

Licentiates in Acupuncture, Chinese Herbs, Amatsu (Active Balance)


Japanese Medicine
Diplomas in Acupuncture, Tuina, Chinese Nutrition, Medical Qi Gong,
Nutrition, Stress Management, Anatomy & Physiology, Swedish
Massage, Reflexology.
9 Clinical Internships in hospitals in China.
Visiting lecturer to Beijing University of Chinese Medicine and Zhejiang
University of Chinese4 Medicine
Founder & Academic Director of Active Health Foundation.

Tuina
Chinese Medical Acupressure
By

James OSullivan Lic.Ac. C.Ac. (China)

Introduction.
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A journey of a thousand miles,


must begin with a single step

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Active Health Foundation

When the student ready The teacher will appear

Active Health Foundation is the Tuina accrediting body for


Ireland,
similar to ITEC, CIBTAC, FETAC,

Established in 1999
Practitioner Qualifications recognised throughout Europe and
USA
Recognition towards Acupuncture
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Tuina Recognition!

Accreditation
Affiliated with

World Health Organisation

BUCM the largest college of Traditional medicine in China,


where our graduates can complete their clinical training in the
23 teaching hospitals.
BUCM, are the World Health Organisations representative in
Traditional Medicine.
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World Federation of
Acupuncture Societies
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Register for Tuina

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Register for Tuina

When we have your details


You will be sent an email with a link to a webpage
that contains all that weeks information to study
Tuina

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www.activehealth.ie/tuina
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Tuina

Textbook September 2016

Colloquial name: Needle-less Acupuncture

Practical Chinese Medicine

Purchase Link at activehealth.ie/tuina

The most powerful hands-on treatment in


existence!

List Price: 25.00


Postage via LULU: 5
Total: 30
Group Buy
20
Must be paid in class Wednesday 28th September 2016

Uses the same Qi points as


Acupuncture

Link to online book store here: www.activehealth.ie/tuina


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Why are you here?

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Benefits of the Tuina qualification?

What benefit will Tuina be to my practice

Set up your own clinic offering health treatments for conditions


such as:

Its can diagnose and treat nearly all medical conditions


It can be offered as a therapeutic therapy alone
First step towards acupuncture training
Clinical Experience in Chinese Hospitals
Its not offered by many other therapists
It has a unique appeal with the public

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Sports injuries, Back pain, Insomnia, Migraine, Headaches,


Dysmenorrhoea, IBS, Cystitis, Asthma, Hypertension, Constipation,
Bedwetting, etc, etc.
Therapeutic Massage

Work in a Health Centre, Beauty Salon, etc


Work on the Cruise Ships
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Some Financial Projections

Costs: 15 hours = renting over 3 days at 50 per day = 150


Promotion: 4 hours per week
Assumptions: A self employed Tuina practitioner earns
(average) 50 per hour
15 patients/clients per week = 750

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Skilful Hands
Restore Spring

Study Advice

Get to know the terms and language of your subject


Study read about the subject and ask yourself Do I
understand that?
Pace yourself time management
Write what you know in your own words
Dont listen to negative messages.
Relax it will all happen in its own time
BELIEVE YOUR TEACHER!!!
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Clinical Experience in China!

When you talk, you are only repeating what you already know.
But when you listen, you may learn something new

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Become an Acupuncturist

Teachers open the Door


You Enter by Yourself

Recognised by the World Health Organisation


A prestigious therapy in Healthcare
Treat a very wide range of conditions
The fastest growing preferred therapy of Irish patients

History

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Huang Di

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Huang Di Nei Jing

or Yellow Emperor is regarded as the predecessor


of the Chinese race. He made many important
contribution to the Chinese people, the most
important being the compilation of the medical
classic, Huang Di Nei Jing or The Yellow
Emperors Medicine Classic.

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The Classic is divided into 18 scrolls and 162


fascicles. It comprises Su Wen Simple
Questions (nine scrolls) and the Ling Shu (nine
scrolls). Su Wen is on the theory of maintaining
good health and treating disease.

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Qi Bo

Tuina Chinese Medical Acupressure

The sage practices the Tao in his daily life, while


the uneducated turn their backs to it. To live in
harmony with Yin and Yang means life, to act
contrary means death. This is the reason the
sage does not treat those who are already ill, but
rather those who are not yet diseased. To treat
after one is diseased is like attempting to restore
order only after unrest has broken out. It is like
waiting till ones thirsty to begin digging a well or
forging spear's after the battle is underway.

was a physician and an official of Huang Di. He


is referred as Heavenly Master in the
Huang Di Nei Jing.
In ancient times, people used to live to over 100 years and they
were still athletic, robust and vigorous. Whereas today (meaning
about 2,200 years ago), most people age quickly and become frail
when they are about 50. They suffer diseases that our ancestors
could weather.
Is it because the time has changed? or are humans on the way
towards extinction?

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History of Tuina

Ancient Times treatment health were carried out by


Shamans or hermits
Developed over 4,000 years ago
Confucius code of conduct based on lifestyle in harmony
with forces of the universe
Part of Traditional Chinese Medical System (TCM)

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Early Records

First reference to massage found on engravings on tortoise shells


& bones c.1600-1100BC
Tuina as a name was established during the Ming
period (1368-1644AD) to distinguish it from folk
massage as a medical therapy.
Folk massage was called Anmo & Anfu
Practiced today alongside allopathic medicine in
modern hospitals
Recognised by the World Health Organisation

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Meridians

History of Acu Points

Legend says study of puncture wounds on warriors led to


development of Acupuncture

Jing Luo - Meridians


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Cultural Circumstances

Western View

Language
Translations
Simplicity is its essence
Culture plays an important role in the
development of any healing or medical system
as it presents the philosophy that defines the
way the system works.
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Western science strives to break everything


down, (known as reductionism).
The body as a machine

analogous to man-made machines, such


as cars, CD players, or space capsules

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Eastern View

Holism - Nature and landscapes

Traditional Chinese Medicine strives to see the


whole picture, nothing is excluded, nothing is
analysed or interpreted without reference to the
whole.
In Traditional Chinese Medicine everything is
interdependent, including the environment.
The body is seen as a garden or microbiome
Holistic Health Picture
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Herbal Therapy
Nutritional Therapy
Acupuncture
Cupping Therapy

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Herbal Medicine

Chinese Medical Acupressure

Moxibustion
Gua Sha
Medical Qi Gong -Exercise

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Nutritional Therapy

An Apple

Eating your way to health and well being

Chinese food therapy is a practice of healing using natural foods


instead of medications.
Five Elements theory.

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Garlic

Taste: Pungent; Sweet


Energy: Warm
Meridian: Spleen; Stomach; Lung
Effects: Strengthen Stomach; Warm the Zhong (middle) Jiao
Application: Abdominal pain; Dysentery; Pertussis (Whooping
cough); TB

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Has 12 Vitamins and 13 Minerals.


Plus 386 other phyto-nutrients.

Enzyme Complex.
Flavanoid Complex.
Carotenoids.
Indole Carbinols.
Polyphenols.

Quality:

Abundant Qi

Nature:

Cooling!

Taste:

Sweet and Sour

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Acupuncture

Ultra fine needles


Acupuncture needles are pre-sterilized, individually packaged
and disposable
Complementary

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Medical Qi Gong

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Cupping Therapy

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Gua Sha

Moxibustion

Acupuncture-Moxibustion

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Empirical Observation

The Chinese have studied humans and our interaction with the
environment for thousands of years.
They observe when someone is behaving in a certain way, other
events may be happing at the same time.
In health: accompanying signs and symptoms or the Clinical picture
Behaviour
Sneezing

Insomnia

Headaches

Painful Periods

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Associated event

Cold weather, recent epidemic, runny eyes and nose,

Empirical Observation

An example of empirical observation may


be the discovery of a herbal remedy.
Where the sage is sitting beside a tree and
some leaves drop into his pot of soup.
The result is better health or the relief of
some symptoms.

Stress, drinking stimulants, anaemia,

Runs in family, stress, weather or food related,

Irritable, distended breasts, clots,

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Four Diagnostic Methods

Getting our Bearings!


Vital Substances

Yin & Yang

Qi. Blood, Body Fluids,


Essence, Shen

Five Phases /
Elements

Zang Fu (Organs)

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Pathogenic
Factors

Observation

Listening

Asking

Palpation

14 Meridian
365 Acu points

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Diagnostic
Methods

Signs &
Symptoms

(Clinical Picture)
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Signs &
Symptoms
Pattern
Differentiation
Point Location &
Function

Principal of
Treatment

Patterns of Disharmony

Treatment Techniques

Treatment

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Cultivate

means to nourish,
tonify, strengthen,
grow, promote,
nurture

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Action Words

Learning Traditional Chinese Medical Tuina

You cannot learn by rote


It is a complete new schema of health and life.
It may seem difficult, but it is a very simple concept, if you take it
one step at a time
Learning is like completing a jigsaw puzzle without the picture
clue.

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Definition of Tuina

Subdue

means to clear,
eliminate, reduce,
calm, bring down,

Regulate

Tuina is the study and practice of a series of Chinese manual


clinical techniques which are used to prevent and treat
disease, based on the principles of Traditional Chinese
Medicine

means to balance
or harmonise
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Tuina

Uses the same Qi points as Acupuncture


Activates the meridians and channels
Acts directly on the body and channels to regulate unhealthy
organs and tissues
Balances Yin & Yang
Regulates circulation of Qi and Blood
Normalise the function of the Zang Fu (organs)
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A comprehensive therapy:

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Tuina

Internal and External conditions


Traumatic injury & Musculo-skeletal problems
Obstetrics & Gynaecological issues
Paediatrics
Ear, Nose & Throat problems
Strengthens the bodys resistance to disease & prevents invasion of
pathogens

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Tuina

Tui = to push or move along


Na = to hold or grasp

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Simplicity

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Tuina

Manipulations are easy to learn


May be performed by anyone providing they have an understanding
of TCM

Safe and free from Harmful side effects

External therapy
Avoids medicines & surgical procedure
Almost no side effects providing correct diagnosis & manipulations
used

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Tuina

Inexpensive & Convenient


Almost no equipment or special medical facilities required
May be performed anywhere
Costly and difficult hospital visits may be avoided
Specific benefits & Advantages in practice & treatment

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Contra Indications

Severe cardiac, pulmonary and encephalopathic disease or


extreme constitutional weakness
Recent history of bleeding or disease of the Blood
Local skin lesions or skin diseases
Acute communicable diseases
Acute spinal injury or injuries without a clear-cut diagnosis

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The Optimum Tuina Treatment

There are 4 aspects that constitute an effective and beneficial


Tuina Treatment:
Appropriate Duration
Appropriate Force
Appropriate Rhythm
Gentleness

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Contra Indications

Pregnancy, menstruation or postpartum lochia


Psychosis or intoxication
After over-eating
Benign and malignant tumours
Severe degenerative disease e.g. osteoporosis

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Indications

Yin

Musculo-skeletal disease and trauma


Internal diseases
External diseases
Paediatric diseases
Ear Nose & Throat conditions

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Yin and Yang is one of the most fundamental concepts in


Traditional Chinese Medicine
It is a very important element of Chinese Medicine, because in
order to treat disease, we always attempt to balance Yin &
Yang.
The earliest reference to Yin and Yang is in the Huang Di Nei Jing

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In the beginning

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Yin Yang Balance


(Homeostasis)

Qi was formless
The dance of
Yin and Yang
The dance of Qi

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Yang

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Yin

Yang

Yin

The concept of yin and yang describes


two opposing and, at the same time,
complementary aspects of any one
phenomenon

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Yin
"shady place, north slope, south
bank (river); cloudy, overcast";
qualities are characterized as
passive, dark, feminine, negative,
downward-seeking, consuming
and corresponds to the night.

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Yin

Yang

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Yin

Yang

The five main aspects of Yin Yang Relationship


1. Yin-Yang as opposites
2. Interdependent
3. Inter-transformation
4. Infinite Divisibility
5. Mutual consumption

Yang
"sunny place, south slope, north
bank (river), sunshine"; qualities
are characterized as active, light,
masculine, positive, upwardseeking, producing and
corresponds to the daytime.

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Yang

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Yin-Yang as Opposites
Yin

Water
Cold
Quite
Dense
Wet
Soft
Inhibition
Slowness
Inside

Inter Dependence

You cannot have one without the other


No hot without cold
No outside without inside
No day without night

Yang

Fire
Hot
Restless
Light
Dry
Hard
Excitement
Rapidity
Outside

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Inter Transformation

Infinite Divisibility

One can change into the other, but it is not a random event,
happening only when the time is right.
Spring Summer Autumn Winter

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Yin Organs
Heart
Pericardium
Spleen
Lungs
Kidney
Liver

Yang Organs

Mutual Consumption

Small Intestine
San Jiao
Stomach
Large Intestine
Urinary Bladder
Gall Bladder

Is where one consumes the other in


disharmony
When Yin & Yang are balanced you
have optimum health
When Homeostasis is balanced you
have optimum health
Equilibrium

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Full Cold
Optimum
Health

Yang

Yin

Full Cold Pathogen

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Yang

Yin

Balance

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Self Study Cold

Clinical Manifestation:
Cold limbs, weakness,
contracture, pain improved with
heat
Tongue: pale or bluish
Pulse: slow, full

Optimum
Health

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Make a list of points that would dissolve Cold


1. ..
2. ..
3. ..
4. ..
5. ..
6. ..
Hint: Think scatter, dispel, eliminate, reduce, maybe look to points that increase Yang or Heat

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Clinical Manifestations:
Restlessness, headache,
irritability, pain worse with
pressure and in a warm
environment

Full Heat

Tongue: red, maybe thick yellow


coat
Pulse: full, rapid

Self Study Heat

Optimum
Health

Yang

Yin

Full Heat Pathogen

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Yang Deficiency
Optimum
Health

Yang

Yin

Empty or Deficiency Cold

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Hint: Think clear, reduce, subdue,

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Self Study Yang Deficiency

Clinical Manifestation:
hands and feet maybe cold,
fatigue, weakness, pain which
improves with heat and pressure,
Tongue: pale, swollen, wet
Pulse: slow and weak

Make a list of points that would cool Heat


1. ..
2. ..
3. ..
4. ..
5. ..
6. ..

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Make a list of points that would Cultivate Yang


1. ..
2. ..
3. ..
4. ..
5. ..
6. ..
Hint: Think strengthen, nourish, tonify, invigorate, raise even points that rescue or restore Yang

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Yin Deficiency

Self Study Yin Deficiency

Clinical Manifestations:
Feeling hot particularly in the
evening or night, night sweats,
heat in the 5 palms, hot flashes,
insomnia,
Tongue: red, no coat
Pulse: rapid, empty

Optimum
Health

Yang

Yin

Empty or Deficiency Heat

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Mutual Consumption

Make a list of points that would Cultivate Yin


1. ..
2. ..
3. ..
4. ..
5. ..
6. ..
Hint: Think strengthen, nourish, tonify, invigorate

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A little about the 8 principals

Basically this is the method used to diagnose


disharmony.
The Four questions
Interior
Deficiency
Cold
Yin

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Exterior
Excess
Hot
Yang

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Case History

Peter, 23 years old, Welder


Clinical Manifestations: headache thats worse in a hot
environment, fatigue, smelly stools, dark yellow urine, Tongue:
red, dry. Pulse: rapid, full
What's your Diagnosis: ?
What Principal of Treatment: ?
What Prescription of Points: ?
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Case History

Petra, 24 years old, office


Clinical Manifestations: headache thats worse at night, fatigue,
smelly stools, yellow urine, red cheeks, tossing and turning at
night, feeling hot at night. Tongue: red, no coat Pulse:
rapid, empty
What's your Diagnosis: ?
What Principal of Treatment: ?
What Prescription of Points: ?
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Case History

Petula, 35 years old, factory worker


Clinical Manifestations: insomnia, tiredness, restless sleep
feeling cold, needs got water bottle, abundant clear urine, Cold
hands and feet, water retention in feet. Tongue: Pale with
blue tinge Pulse: Slow, Empty
What's your Diagnosis: ?
What Principal of Treatment: ?
What Prescription of Points: ?
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Review Questions
Question:

Value: one mark

What are the 4 Aspects of Tuina Massage, the practitioner should


observe to perform a competent treatment ?.
A: Appropriate Duration, Force, Rhythm and Gentleness

B: Appropriate Technique, Force, Rhythm and Gentleness


C: Appropriate Duration, Pressure, Force and Gentleness

D: Appropriate Duration, Force, Rhythm and Calmness


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Review Questions

Review Questions

Question:
Value: one mark
Culture plays an important role in how a medicine is
understood?
true or false

Question:
Value: one mark
The Yellow Emperor's book is called the Nei Ting ?
true or false

Question:
Value: one mark
Empty Cold arises from a deficiency of Yang ?
true or false
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Review Questions

Question:
Value: one mark
Yin can have a unhealthy effect on Yang?
true or false

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Tuina

Question:
Value: one mark
Another name for a Yin Deficiency?
A: Full Heat
B: Full Cold
C: Empty Heat
D: Empty Cold
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Question:
Value: one mark
All disharmonies in a human being are due to an
imbalance of (What)?
A: Yin & Yang
B: Zang Fu
C: Qi & Blood
D: Eight Principals

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Course Content

Historical development of Tuina


Definition of traditional Chinese medical acupressure massage
Contra-Indications to Tuina Chinese Medical Acupressure Massage
General effects of massage
Psychological and physiological effects of massage
Principal of good massage practice (appropriate duration, appropriate force,
appropriate rhythm, gentleness)

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Yin & Yang

Course Content

Historical development
Nature of Yin & Yang, as two phases of a cyclical movement, as two stages of
transformation. Four aspects of Yin & Yang relationship. Application of Yin & Yang
to Medicine. Yin & Yang and the body structure. Application of the four principles
of Yin & Yang to Medicine. Yin and Yang patterns of disharmony.

Five Elements

Five Elements in nature, as basic qualities, as movement, as stages of a seasonal


cycle, Inter-relationships, correspondences
Five Elements in Chinese Medicine in Physiology, Pathology, Diagnosis,
Treatment, Herbal & dietary therapy

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Course Content

Tongue & Pulse Qualities - The Pillars of Chinese Diagnosis

Qi, Blood, Body Fluids, Essence & Shen (Mind, Spirit). The concept of Qi in
Chinese philosophy, the concept of Qi in Chinese Medicine, The Transformation
of Qi. The concept and functions of Blood, Body Fluids, Essence and Shen. The
interaction of these Vital substances and their pathogenesis and patterns of
disharmony.

The Zang Fu (Internal Organs)

The ancient view of the body organs. The energetic qualities of the Organs and
their functions.
Inter-relationships of the Yin Organs, Inter-relationships of the Yang Organs,

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Tongue:
Body Shape, Texture, Colour, Coating, Moisture
Pulse:
Deep, Floating,
Slow, Rapid,
Empty, Full, Weak,
Slippery, Wiry, Thready, Choppy,

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The Vital Substances

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Course Content

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Course Content

The Meridians or Channels.


Review Surface Anatomy of Skeleton and Muscles for location purposes
Measuring by cun, and dividing the body
Location, Functions and Actions of 70 Major Qi points.

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Course Content

Lung - LU-1, LU-5, LU-7, LU-9, LU-10, LU-11,


Large Intestine LI-01, LI-4, LI-10, LI-11, LI-17, LI-20
Stomach ST-01, ST-02, ST-7, ST-8, ST-25, ST-29, ST-36, ST-40, ST-45
Spleen - SP-1, SP-3, SP-4, SP-6, SP-9, SP-10, SP-15, SP-21
Heart HT-01, HT-3, HT-7, HT-09
Small Intestine SI-01, SI-3, SI-19
Urinary Bladder BL-01, BL-02, BL-13, BL-15, BL-17, BL-18, BL-20, BL-21,
BL-22, BL-23, BL-25, BL-36, BL-40, BL-57, BL-60, BL-67
Kidney - KI-1, KI-3, KI-6, KI-7, KI-10, KI-27

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Causes of Disharmony.

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Course Content

Pericardium PC-01, PC-3, PC-6, PC-7, PC-8, PC-09


San Jiao SJ-01, SJ-4, SJ-5, SJ-6, SJ-10, SJ-23
Gall Bladder GB-01, GB-13, GB-14, GB-15, GB-20, GB-21, GB-30,
GB-34, GB-40, GB-44
Liver LR-1, LR-2, LR-3, LR-8, LR-13, LR-14
Ren RN-1, RN-3, RN-4, RN-6, RN-12, RN-14, RN-17, RN-24
Du DU-1, DU-4, DU-14, DU-20, DU-24, DU-26, DU-28
Extra points - Yin Yang, Tai Yang, Bi Tong, Yu Yao, E Zhong, An Mian
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Course Content

Emotions: Joy, Anger, Sadness, Grief, Pensiveness, Fear, Shock. The emotions and
disharmony (cause and affect)
Climatic conditions:
Wind, Cold, Damp, Dryness, Summer Heat, the intertransformation, interaction and combination of these pathogenic factors.
Internal and External pathogenic factors.
Miscellaneous causes: Life style (poor diet, lack of exercise, overwork), Weak
constitution, trauma, parasites, poisons, wrong treatment, environmental.

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Course Content

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Diagnosis according to Traditional Chinese Medicine.


Eight principals of Traditional Chinese Medical diagnosis:

Exterior
Deficiency
Yin
Hot

- Interior
- Excess
- Yang
- Cold

The Four Examinations:

Observing, Enquiring, Hearing & Smelling, Palpation,

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Course Content

Patterns of Disharmony - the organisation of signs and symptoms of


disharmony. A brief overview of all patterns, with comprehensive
definition of the following:

Wind, Cold, Heat, Dampness,


Spleen Qi Deficiency
Heart Qi Deficiency
Liver Qi Stagnation
Liver Yang Rising
Lung Qi Deficiency
Spleen Qi Deficiency
Kidney Yang Deficiency

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Heart & Kidney not harmonised


Spleen Yang Deficiency
Heart Yang Deficiency
Liver Blood Deficiency
Spleen & Liver Blood Deficiency
Lung Yin Deficiency
Spleen Yang Deficiency
Kidney Yin Deficiency

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Course Content - Extra

Stress, Headaches, Insomnia,


PMS, Diarrhoea, Constipation, Abdominal Pain,
Tennis Elbow, Stiff Neck, Low Back Pain,
Sciatica, Common Cold,

NB: If time allows we will cover


these disharmonies.
Not included in Tuina Examinations

This Tuina course is offered as a module of a Complementary Medicine


course and the student must study all the offered education regarding
becoming a competent practitioner. It is a requirement that the
graduate will hold a recognised Diploma in Anatomy and Physiology.
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Each candidate should obtain at least 3 case histories on 5 people


with a minimum of 15 treatments in total over the course of their
studies to include a range of conditions, ages, and lifestyles. Case
studies are not to be done on classmates in order to show their
understanding of the treatment. Sample case study form is included.

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Review Questions

Pathologies commonly treated by Tuina practitioners in China.

Case Studies

Course Content

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Question:
Value: one mark
What was the name of the Emperor who is said to be the
father of TCM ?
Question:
Value: one mark
What was the name of his book?

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Review Questions

Review Questions

Question:
Value: one mark
Who was the chief adviser to the Huang Di?

Question:
Value: one mark
Name the two books of the Huang Di Nei Jing?

Question:
Value: one mark
Name a popular quote that conveys Qi Bos advice on
health?

Question:
Where is GB-21 located?
A: On the shoulder

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Observation:

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Case History- Name Judy

Value: one mark


B: On the neck

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Review Questions

Question:
Value: one mark
What are the main disciplines of TCM?
Hint: 4

Pale complexion, looks tired, pale tongue body.

Listening:

breathing very shallow, weak voice,

Asking:

Question:
Value: one mark
What does Empirical observation mean?

Fatigue, very tired, Age; 22 Occupation; student,

Palpation:

weak pulse, weak muscles,

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Review Questions

Question:
Where is GB-20 is locate ?

Review Questions

Value: one mark

Question:
Value: one mark
GB-21 and LI-04 cannot be used in what circumstances
(contra indicated to what). ?

Question:
Value: one mark
Does LI-04 eliminate or invigorate?
A: Eliminate
B: Invigorate
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Question:
Value: one mark
Sneezing, Cold weather, recent epidemic, runny eyes and
nose, is what kind of clinical picture?
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Review Questions

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Review Questions

Question:
Value: one mark
What are the four main schools of TCM ?

Question:
A apple has a cooling affect?
TRUE or FALSE?

Question:
Value: one mark
What is the TCM therapy connected to or a sub category
of Herbal medicine?

Question:
Value: one mark
An Irish stew or ginger can help to warm the body?
TRUE or FALSE?

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Value: one mark

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